, Volume 37, Issue 1, pp 87–96 | Cite as

The Current Treatment of Scleroderma

  • G. Fergus Oliver
  • R. K. Winkelmann
Practical Therapeutic


The treatment of scleroderma is determined by the stage of the disease, associated organ involvement or the presence of features overlapping those of other connective tissue disease.

Raynaud’s phenomenon is responsive to vasoactive medication, but recently heat and plasma exchange have been shown to be more effective, reducing the need for systemic medication.

In stages II and III of the disease, administration of non-toxic penicillamine in low doses for 2 to 4 years is the preferred treatment. Plasma exchange may offer some hope in the early stages. The treatment of the renal crisis of scleroderma with angiotensin-converting enzyme inhibitors has reduced mortality from this complication. These drugs are currently the preferred treatment for the hypertension of renal scleroderma.

The symptomatic treatment of the pulmonary, gastrointestinal, and soft tissue complications of scleroderma is also discussed.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alarcon-Segovia D, Ramos-Niembro F, de Kasep GI, Alcocer J, Tamayo PP. Long-term evaluation of colchicine in the treatment of scleroderma. Journal of Rheumatology 6: 705–712, 1979PubMedGoogle Scholar
  2. Asboe-Hansen G. Treatment of generalized scleroderma with inhibitors of connective tissue formation. Acta Dermato-Venereologica (Stockholm) 55: 461–465, 1975Google Scholar
  3. Asboe-Hansen G. Scleroderma. Journal of the American Academy of Dermatology 17: 102–108, 1987PubMedCrossRefGoogle Scholar
  4. Czirják L, Dankö K, Schlammadinger J, Surányi P, Tarnási L, et al. Progressive systemic sclerosis occurring in patients exposed to chemicals. International Journal of Dermatology 26: 374–378, 1986CrossRefGoogle Scholar
  5. Fuchs D, Fruchter L, Fishel B, Holtzman M, Yaron M. Colchicine suppression of local inflammation due to calcinosis in dermatomyositis and progressive systemic sclerosis. Clinical Rheumatology 5: 527–530, 1986PubMedGoogle Scholar
  6. Horowitz M, Maddern GH, Maddox A, Wishart J, Chatterton BE, et al. Effects of cisapride on gastric and esophageal emptying in progressive systemic sclerosis. Gastroenterology 93: 311–315, 1987PubMedGoogle Scholar
  7. Housset E. Intér et de certains dérivés de la colchicine dans le traitement des syndromes sclérodermiques. Annales de Dermatologie et de Syphiligraphie 94: 31–34, 1967PubMedGoogle Scholar
  8. Jablonska S (Ed.). Scleroderma and pseudoscleroderma, 2nd ed., Polish Medical Publishers, Warsaw, 1975Google Scholar
  9. Krieg T, Meurer M. Systemic scleroderma: clinical and pathophysiologic aspects. Journal of the American Academy of Dermatology 18: 457–481, 1988PubMedCrossRefGoogle Scholar
  10. Mascaro G, Cardario G, Bordin G, Tarditi M, Ferraris G, et al. Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis. Journal of Clinical Apheresis 3: 219–225, 1987PubMedCrossRefGoogle Scholar
  11. McCune MA, Winkelmann RK, Osmundson PJ, Pineda AA. Plasma exchange: a controlled study of the effect in patients with Raynaud’s phenomenon and scleroderma. Journal of Clinical Apheresis 2: 206–214, 1983CrossRefGoogle Scholar
  12. Medsger Jr TA. Progressive systemic sclerosis. Clinics in Rheumatic Diseases 9: 655–670, 1983PubMedGoogle Scholar
  13. Medsger TA. D-penicillamine treatment of lung involvement in patients with systemic sclerosis (scleroderma). Arthritis and Rheumatism 30: 832–834, 1987PubMedCrossRefGoogle Scholar
  14. Nimni ME. Penicillamine and collagen metabolism. Scandinavian Journal of Rheumatology 28 (Suppl.): 71–78, 1979PubMedCrossRefGoogle Scholar
  15. Priollet P, Boudot N, Fiessinger J-N, Vayssairat M, Housset E. Traitement de la sclérodermie systémique. Anales de Dermatologie et de Vénéréologie 111: 595–607, 1984Google Scholar
  16. Rodnan GP (Ed.). Progressive systemic sclerosis. Clinics in Rheumatic Diseases 5: 1–306, 1975Google Scholar
  17. Rustin MHA, Almond NE, Beacham JA, Brooks RJ, Jones DP, et al. The effect of captopril on cutaneous blood flow in patients with primary Raynaud’s phenomenon. British Journal of Dermatology 117: 751–758, 1987PubMedCrossRefGoogle Scholar
  18. Seibold JR, Jageneau AHM. Treatment of Raynaud’s phenomenon with ketanserin, a selective antagonist of the serotonin: (5-HT2) receptor. Arthritis and Rheumatism 27: 139–146, 1984PubMedCrossRefGoogle Scholar
  19. Shapiro LS, Prince RK, Buckingham RB, Rodnan GP. D-penicillamine treatment of progressive systemic sclerosis (scleroderma): a comparison of clinical and in vitroeffects. Journal of Rheumatology 10: 316–318, 1983PubMedGoogle Scholar
  20. Steen VD, Medsger Jr TA, Rodnan GP. D-penicillamine therapy in progressive systemic sclerosis (scleroderma): a retrospective analysis. Annals of Internal Medicine 97: 652–659, 1982PubMedGoogle Scholar
  21. Surwit RS, Gilgor RS, Allen LM, Duvic M. A double-blind study of prazosin in the treatment of Raynaud’s phenomenon in scleroderma. Archives of Dermatology 120: 329–331, 1984PubMedCrossRefGoogle Scholar
  22. Traub YM, Shapiro AP, Rodnan GP, Medsger TA, McDonald Jr RH, et al. Hypertension and renal failure (scleroderma renal crisis) in progressive systemic sclerosis: review of a 25-year experience with 68 cases. Medicine (Baltimore) 62: 335–352, 1983Google Scholar
  23. Winston EL, Pariser KM, Miller KB, Salem DN, Creager MA. Nifedipine as therapeutic modality for Raynaud’s phenomenon. Arthritis and Rheumatism 26: 1177–1180, 1983PubMedCrossRefGoogle Scholar

Copyright information

© ADIS Press Limited 1989

Authors and Affiliations

  • G. Fergus Oliver
    • 1
  • R. K. Winkelmann
    • 1
  1. 1.Department of DermatologyMayo Clinic and Mayo Foundation, Mayo ClinicRochesterUSA

Personalised recommendations