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sclerosis
Also
called
scleroderma
Mul2system
disease
of
unknown
e2ology
Pathogenesis
include
immune
system
ac2va2on
,
endothelial
ac2va2on
,
and
broblast
ac2va2on
this
results
in
small
blood
vessels
damage
and
2ssue
brosis.
Epidemiology
Rare
disease
incidence
in
the
US
19/million/ year
and
prevalence
of
19-75/100,000
Rare
in
children
Peak
between
age
35-65
More
women
aected
Family
h/o
other
auto
immune
diseases
Ethnic
background
inuence
survival
and
disease
manifesta2on.
Clinical
features
Raynaud s
Typical
skin
changes
Esophageal
and
small
bowel
dysfunc2on
Inters22al
lung
disease
Pulmonary
hypertension
Renal
crises
Causes
of
Raynaud s
Occlusive
arterial
disease
Rheuma2c
diseases:Scleroderma,CREST,MCTD,SLE,RA,
Myosi2s
Repe22ve
vascular
injury
Hyperviscosity
:Polycythemia,Cryoglobulinemi a
Thoracic
outlet
syndrome
Microstomia
CREST
Calcinosis
Raynaud s
Esophageal
dysmo2lity
Sclerodactyly
Telangiectasias
Calcinosis
Sclerodactyly
Skin
changes,and
exion
contactures
Telangiectasias
Dilated
capillaries
seen
over
the
face
Diagnosis
Clinical
features
ANA
posi2ve
90%
An2
topoisomerase
1
an2body
posi2ve(scl-70)
30%
in
diuse
An2centromere
an2body
posi2ve
in
CREST
and
limited
scleroderma
Treatment
Skin
:no
eec2ve
treatment,60%
improve
with
2me
Treat
hypertension
early
and
aggressive
to
prevent
renal
damage
and
other
hypertension
complica2ons
Calcium
channel
blockers
may
help
Raynaud s
Treat
ILD
and
pulmonary
hypertension
Avoid
steroids(may
provoke
renal
complica2ons)