bubble_chart Overview

Scleroderma is divided into localized and systemic types. The former primarily affects the skin, characterized by progressive edema, sclerosis, and atrophy of the skin. The latter, in addition to skin involvement, can also affect multiple organs throughout the body, such as the esophagus, gastrointestinal tract, lungs, and kidneys. Localized scleroderma is more common than systemic scleroderma.

bubble_chart Etiology

Cause of disease: The cause of scleroderma is unknown, with current theories mainly including the immunological theory, abnormal collagen synthesis theory, and vascular theory.

bubble_chart Clinical Manifestations

The rash initially appears as one or several pale red patches of varying sizes and shapes, with slight edema, and edges slightly raised above the surrounding normal skin. Over weeks to months, it gradually expands and hardens, turning pale yellow or ivory in color. The surface becomes tight, smooth, and wrinkle-free, firm to the touch, and cannot be pinched up. Sometimes, a faint purplish-red halo may be seen at the edges, indicating the active expansion zone of the lesion and signaling the disease's active phase. The base adheres to the subcutaneous tissue, with the surface slightly depressed, dry skin without sweating, and loss of vellus hair. As the condition progresses, the skin eventually atrophies and thins, possibly exhibiting grade I pigmentation or depigmentation. The rash can vary in shape, appearing as droplets, patches, or bands (strips). It may range in size from coin-sized to over ten centimeters in length. It can occur anywhere on the body, commonly on the forehead, cheeks, chest, abdomen, buttocks, or extremities. When it affects the scalp, it can cause sclerotic atrophic patchy alopecia areata. Band-like lesions often appear near the midline of the forehead, resembling a knife-cut, and some patients may experience facial hemiatrophy. The disease progresses slowly, usually without subjective symptoms, though local sensation may become dull in the late stage (third stage). This condition is more common in women than in men.

bubble_chart Treatment Measures

This disease requires patient and persistent treatment, often combining Chinese and Western medical methods. The following therapies can be selected for use.

(1) Oral administration of Vitamin E, 0.1g each time, three times daily.
(2) Local injection: For small lesions, use 1% procaine or 2% lidocaine mixed with triamcinolone acetonide suspension (5–10mg/ml) or prednisolone suspension (2.5mg/ml) for intralesional injection. For larger lesions, injections can be administered in multiple points and batches, once every 2–3 weeks. The lesions will gradually soften, and injections should be discontinued if skin atrophy occurs.
(3) Physical therapies such as audio frequency therapy, helium-neon laser, wax therapy, tuina, etc.
(4) Chinese medicine therapy: The method of softening hardness and dissipating mass can be used. A prescription example is Oyster Shell Turtle Carapace Decoction: calcined oyster shell 30g, vinegar-prepared turtle carapace 15g, light kelp 15g, Uncaria 30g, Salvia 15g, Floweringquince Fruit 9g, Luffa Vegetable Sponge 9g, Corydalis Tuber 9g, seaweed 15g. Decoct one dose daily for oral intake. Compound Salvia Injection, Root Leaf or Flower of Common Threewingnut, etc., can also be used. Alternatively, thin-covered Ganoderma Injection can be administered intramuscularly, or 2% procaine can be added to the above injection for subcutaneous administration around the sclerotic plaques.