Scleroderma folk remedies. Treatment of systemic scleroderma. Basic principles of treatment

Among autoimmune diseases, scleroderma is very common. What is it and how to treat such a disease? The pathology affects the skin, connective tissue, musculoskeletal system, and in some cases, internal organs. The etiology of the disease is associated with a dysfunction of the immune system. Protective cells that normally fight germs begin to destroy own fabrics. Severe damage to the skin and connective tissue occurs. Often the patient becomes disabled due to scleroderma. ICD-10 classifies this pathology as systemic sclerosis, disease code M34.

What is scleroderma?

Among autoimmune processes, scleroderma ranks second in prevalence after The disease is chronic and progressive. The skin and connective tissues undergo scarring, which leads to disruption of tissue metabolism and blood circulation in small vessels. Collagen is formed in excess quantities, sclerosed and hardened. In the systemic form of the disease, serious damage occurs internal organs.

Most often, women suffer from scleroderma. The disease is usually diagnosed in middle age, but skin lesions are often detected in children or adolescents. There are 2 forms of scleroderma: focal and systemic. In the first case, the disease proceeds more easily.

Focal scleroderma

With focal scleroderma, individual areas of the skin are affected. Sometimes changes occur in the bones and muscles. Internal organs are not affected by the pathological process. There is no vascular spasm, which is accompanied by numbness of the fingers (Raynaud's syndrome). The disease is often detected in childhood. More often girls suffer from this disease. Doctors give a relatively good prognosis for this type of scleroderma. The focal form of the disease is divided into several types:

Ring-shaped. Plaque-like spots appear on the skin. They are brown in color.
Linear. White stripes of scar tissue appear on the face. They look like a line.
Plaque. Manifests itself in the form of redness of areas of the skin due to the expansion of small blood vessels, as well as seals on the body, arms and legs. In the affected areas, secretion stops sebaceous glands, the skin pattern disappears and hair falls out.
Idiopathic atrophoderma Pasini-Pierini. This rare form The disease is observed in young women. Purple spots form on the back; rashes on the face are not typical for this type of scleroderma. Over time, formations on the body progress.
Parry-Romberg facial hemiatrophy. The disease begins in childhood or adolescence. Yellow or bluish spots form on one half of the face, which creates a strong cosmetic defect. The pathological process can affect not only the skin, but also musculoskeletal tissue.

Buschke's scleroderma. Swelling occurs on the skin of the face, neck and shoulders. They are dense and painful on palpation.
Guttate (“white spot disease”). White spots appear on the face of a child or adult. The rashes are convex, with a pearlescent tint. The size of the formations is from 0.5 to 1.5 cm. Often this type of disease is combined with the plaque form of scleroderma. Photos of the stains can be seen in the photo.

Systemic scleroderma

It is characterized by damage not only to the skin, but also to internal organs. Raynaud's syndrome is evident. This form of the disease is divided into the following types:

Diffuse scleroderma. First, the skin of the entire body is affected, and then the pathological process spreads to the internal organs.
Scleroderma. There are no skin manifestations, painful changes occur only inside the body.
Juvenile scleroderma. The disease begins in children and adolescents, the pathology affects the skin, bones and internal organs.
Eosinophilic fasciitis (Shulman syndrome). Where the veins pass through, an “orange peel” appears on the skin, similar to cellulite. This phenomenon is accompanied by severe swelling of the limbs.
Limited scleroderma. Small lesions form on the skin of the legs and arms. With timely treatment they disappear. In the absence of therapy, the pathology spreads to the internal organs.
Cross shape. Scleroderma is combined with other autoimmune processes - or rheumatoid arthritis.

Causes of the disease

The causes of this disease are not fully understood. It is assumed that the development of pathology is influenced by genetic factors. There is a hereditary predisposition to autoimmune diseases. This does not mean that the disease will appear immediately after birth; the pathology can develop at any age.

In people prone to scleroderma, the following factors can trigger the onset of the disease:

past infections;
hormonal disorders;
hypothermia (especially of the legs);
molecular mimicry of microorganisms, which results in increased activity of lymphocytes;
hormonal disorders;
intoxication with drugs or chemicals;
poor ecology of the place of residence;
work associated with harmful effects (for example, in chemical production).

The environment and human health are closely interconnected. Very often, the development of scleroderma is provoked by living in a region with a large number of industrial enterprises. This is especially true for the juvenile form of the disease, which manifests itself in early age. Harmful effects may have silica, white spirit, welding gases, ketones, solvents, trichlorethylene. Not every person whose work involves these substances will necessarily develop the disease. But when hereditary predisposition risk of scleroderma due to constant contact with chemical compounds very big.

Skin symptoms

Symptoms of the disease depend on its type. Skin changes go through several stages of development. First, dense swelling appears, usually located on the arms and face. Then the skin thickens and late stages pathologies, atrophic processes are observed.

The following external signs of the disease can be identified:

Raynaud's syndrome. Numbness, burning and tingling of fingers and toes. Such phenomena are observed even with slight freezing. The skin of the extremities becomes pale and bluish. This symptom is associated with spasm of the blood vessels of the arms and legs.
The skin on the fingers becomes rough. Scar tissue appears. Lesions on the skin of the hands are accompanied by thickening and deformation of the fingers. Because of this, the disease is often mistaken for rheumatoid arthritis.
Purse-shaped folds can be seen around the mouth.
Skin pigmentation.
Feeling of constant chilliness, the patient often and quickly freezes.
With a drop-shaped form, white spots on the face of a child or adult become the first sign of the disease.
Facial expressions disappear. The face becomes smooth and mask-like, the nasolabial fold is almost invisible.

In addition, the person loses a lot of weight, gets tired quickly and complains of headache. Rashes appear on the body. Their color can vary from brown to red. The nature of the rash depends on the form of scleroderma. Photos of the stains can be seen in the photo above.

Manifestations from internal organs

The systemic form of scleroderma affects the entire body. The patient may complain about negative manifestations from different systems. Most often, changes are observed in the kidneys, lungs and heart. There are often changes in digestive organs, which is manifested by the following symptoms:

heartburn;
flatulence;
diarrhea;
ulcerations on the walls of the stomach;
difficulty swallowing;
disturbances of peristalsis;
deterioration in food processing.

If the pathological process affects the kidneys, the following symptoms may be observed:

rare urination;
protein and red blood cells in urine analysis;
arterial hypertension;
renal failure;
disorders of consciousness.

Heart damage may manifest itself as the following:

left ventricular dysfunction;
myocardial compaction;
inflammation of the serous and muscular lining of the heart;
dyspnea;
tachycardia;
heartache;
heart failure (rare).

If the lungs are involved in the pathological process, then the following manifestations are observed:

cough without phlegm;
shortness of breath during physical exertion;
inflammation of the pleura and lungs with the formation of scars and seals;
increased risk of developing lung cancer.

In addition, peripheral nerve damage may occur. Pain occurs in the limbs and face along the way trigeminal nerve. The patient complains of numbness or loss of sensitivity in the arms and legs. IN severe cases paresis (paralysis) is possible. From the outside endocrine glands Possible decreased function of the thyroid gland (hypothyroidism).

Disease prognosis

Patients are often confused when they hear the diagnosis of scleroderma. What is it and how to treat this disease? This question worries patients. We can say that today this disease cannot be completely cured. It is impossible to stop the increased formation of collagen. Modern therapy can only slow down the development of pathology.

The prognosis for the focal form of scleroderma is more favorable than for the systemic one. The average survival rate for this disease is about 68% over 5 years. The effectiveness of treatment depends on the following factors:

Patient's gender. The disease has a more unfavorable prognosis in men.
Patient's age. Scleroderma is less responsive to treatment in people over 45 years of age.
The degree of damage to internal organs. If in the first 3 years of the disease the lungs and kidneys were involved in the pathological process, then the prognosis of the disease worsens.
A decrease in hemoglobin in the blood, an increase in ESR and the presence of protein in the urine indicate a severe form of the disease.
The unfavorable factor is early start diseases before the age of 20 years.

Is scleroderma dangerous? Without treatment to restrain the development of the disease, this pathology can lead to very severe consequences. Autoimmune disease may cause life-threatening complications such as renal and heart failure, pulmonary hypertension, necrosis of the fingers due to circulatory disorders.

Diagnosis of the disease

Which specialist should you contact if the patient notices symptoms similar to those of scleroderma? A rheumatologist treats connective tissue diseases of autoimmune origin. After collecting an anamnesis, external examination of the patient, listening to the heart and lungs using a phonendoscope, the following examinations will be prescribed:

clinical blood and urine analysis;
blood test for antibodies to scleroderma;
capillaroscopy;
biopsy of affected tissue;
and internal organs;
echocardiography;
respiratory function studies;
CT scan to detect changes in tissue.

A rheumatologist will answer all the patient’s questions about scleroderma. What it is and how to treat the disease will become known after the diagnostic results, when the form and nature of the pathology are revealed. You may need additional consultation with specialists: urologist, cardiologist, pulmonologist, dermatologist.

Treatment of scleroderma

In the treatment of scleroderma, drugs are used to reduce collagen production, non-steroidal anti-inflammatory drugs, and drugs to suppress collagen production. immune system.

The most commonly prescribed antifibrotic agent is Cuprenil. The drug helps remove copper from the body. The use of the drug leads to a decrease in the activity of scleroderma. Copper reduces the production of the enzyme that processes collagen. Therefore, removing this substance from the body improves the condition of patients and slows down the pathological process in the connective tissue.

Another popular antifibrotic agent is Lidaza. This is an enzyme that is obtained from the seminal glands of large cattle. The drug has the property of breaking down hyaluronic acid, which is involved in the formation of collagen. The drug Longidaza has the same properties.

Penicillin antibiotics are often prescribed together with Lidase. The exact mechanism of action of these drugs in scleroderma is unknown. However, their use leads to the necessary therapeutic effect. Penicillins are thought to have antifibrotic and anti-inflammatory effects.

Nonsteroidal anti-inflammatory drugs are prescribed for low disease activity and complaints of joint pain. These are the drugs "Ortofen", "Indomethacin", "Nise", "Ibuprofen", "Diclofenac", "Piroxicam". In addition to tablets, local anesthetic ointments may be prescribed for application to the affected areas.

Hormonal drugs and cytostatics are used to suppress the immune system. Glucocorticoids are usually prescribed when disease activity is high. Their dosage is carefully calculated, since these drugs can cause side effects, such as Itsenko-Cushing syndrome (obesity, red moon-shaped face, increased blood pressure, dysfunction of the gonads). TO hormonal drugs relate:

"Metypred";
"Prednisone."

Cytostatic drugs reduce the production of immune cells: T and B lymphocytes, which are auto-aggressive. Such medications include:

"Azathioprine."
"Plaquenil".
"Methotrexate".
"Cyclophosphamide".
"Cyclosporine."

For highly active scleroderma, pulse therapy is prescribed: intravenous drip administration of large doses of cytostatics and hormones. Scleroderma is treated. Medicines to improve blood microcirculation are prescribed: Dipyridamole, Pentoxifylline, Iloprost, Alprostadil, Warfarin. Often prescribed vasodilators: "Amlodipine", "Verapamil", "Nifedipine".

If the digestive tract is damaged, antibiotics are indicated: Erythromycin, Amoxicillin, Metronidazole and the prokinetic drug Metoclopramide. As additional methods of treatment, the doctor may prescribe hemosorption, plasmapheresis, physiotherapy, and exercise therapy.

It is important for all patients with scleroderma to remember that with this disease it is very harmful to be under direct sun rays. It is better to avoid sunbathing and visiting a solarium. Excessive exposure to ultraviolet radiation can nullify the effect of therapy.

Alternative medicine

Patients often wonder: is it possible to treat scleroderma with folk remedies? Of course, to be completely healed from this complex disease It is not possible with home remedies alone. The use of folk remedies is permissible only after consultation with a doctor, as an addition to the main therapy. The following recipes are used:

Aloe juice is applied in the form of compresses to the affected areas. You can use ichthyol ointment.
Baked onion crushed and mixed with one part honey and two parts kefir. This mixture is used for compresses.
Make homemade ointment from melted pork fat and dry herb wormwood or celandine.
To restore connective tissue, ingest decoctions of horsetail, lungwort, and knotweed.
For heart complications, a decoction of adonis and cyanosis will help, and for kidney damage, formulations with bearberry and lingonberry leaf are useful.

New developments in the treatment of scleroderma

Medical scientists have long been studying the nature of scleroderma: what it is and how to treat this complex and serious illness. After all traditional ways Therapy does not lead to complete elimination of the disease. New methods of treatment are being searched, drugs are being developed that can more effectively influence the pathology.

A new genetically engineered drug, Tocilizumab (Actemra), has been created. This drug is an antibody to interleukin-6 receptors. It is this anti-inflammatory cytokine that is the provoking factor in the occurrence of scleroderma and rheumatoid arthritis. Clinical researches showed the effectiveness of the drug.

New proposed complex method therapy with the enzyme "Lidase" in combination with vitamin preparations "Pantogam", "Dexpanthenol" and "Picamilon". This method is effective for focal forms of the disease. Biologically active substances help improve metabolism in affected tissues.

Currently, research is being conducted on drugs that could block the signaling pathway for the development of scleroderma. Inhibitor molecules that can affect the pathogenesis of the disease are being studied. This could help prevent fibrosis, an overgrowth of connective tissue. New developments in the treatment of scleroderma are also associated with the use of stem cells. They are able to replace diseased cells. This leads to a decrease in fibrosis and the formation of new blood vessels to replace those that were damaged by pathology.

Disease prevention

Due to uncertainty about the exact causes of the disease specific prevention scleroderma has not been developed. For people with a genetic predisposition to autoimmune pathologies, following these rules will help reduce the likelihood of the disease:

It is necessary to promptly treat infectious diseases.
Avoid hypothermia and exposure to harmful chemical factors.
Lead an active lifestyle to maintain the tone of the musculoskeletal system and connective tissue.

Patients diagnosed with scleroderma need to register with a dispensary and regularly visit a rheumatologist. Prescribed medications must be taken continuously, and in many cases lifelong maintenance therapy is required.

This is a disease characterized by damage to the connective tissue of the skin and internal organs (esophagus, lungs, musculoskeletal system, gastrointestinal tract, heart, kidneys). Scleroderma is characterized by a predominance of fibrosclerotic and vascular changes. The disease can be localized and systemic. The first type affects only the skin, and the heart, lungs, kidneys and organs of the gastrointestinal tract are affected by the second type of disease with medical term scleroderma.

Symptoms of the development of scleroderma

This disease is a progressive disease of connective tissue with changes in the skin, musculoskeletal system, internal organs and widespread vasospastic disorders, vascular damage such as obliterating endarteritis.

Histologically, with symptoms of scleroderma in the early stages of the process, swelling of collagen fibers, an inflammatory reaction with a perivascular or diffuse infiltrate, consisting mainly of lymphocytes with an admixture of plasmacytes, histiocytes and small quantity eosinophils. In the stage of sclerosis inflammatory phenomena disappear, and bundles of collagen fibers become homogenized and hyalinized.

The diagnosis is made based on clinical picture. From laboratory methods with limited scleroderma, histological examination is of greatest importance; with diffuse scleroderma, in addition, the detection of antinuclear and anticentromere antibodies, the nucleolar type of luminescence in the immunofluorescence reaction. The prognosis depends on the stage and form of the disease. It is least favorable in the systemic form of the disease, especially in the generalized form, accompanied by damage to many internal organs, which often leads to death. With limited scleroderma, the prognosis is good in most cases.

The main syndromes of scleroderma: allergic, inflammatory, metabolic disorders of connective tissue, microcirculation disorders.

Forms of scleroderma and its manifestations

Distinguish

limited (plaque, linear),

Pasini-Pierini atrophoderma,

white spot disease – lichen sclerosus et atrophicans, and

systemic scleroderma.

Plaque form of the disease (sclerodermia en plaques, morphea). The most common form of limited scleroderma, characterized by the presence of single or multiple lesions of various sizes (1–15 cm or more), oval, round or irregular in shape, located on the trunk and limbs, sometimes unilaterally. In its development, the lesion goes through 3 stages: erythema, induration and atrophy. The stage of erythema is little noticeable to the patient, since there are no subjective sensations, the erythema is slightly inflammatory, bluish-pink in color.

Then, in the central zone, with symptoms of scleroderma of this form, a surface compaction appears, which becomes waxy. White color(ivory type), along the periphery of which a narrow lilac rim is visible, the presence of which indicates the continued activity of the process. On the surface of individual lesions there may be blisters, sometimes with hemorrhagic contents. The occurrence of blisters is associated with a violation of carbohydrate metabolism. When the lesion regresses, atrophy and hyperpigmentation remain.

Linear form (sclerodermia linearis) occurs less frequently. It usually occurs in childhood, mainly in girls. Foci of scleroderma of this form can be located on the extremities (sclerodermia striata), causing atrophy of deep tissues, including muscles and bones, limiting movement if the strip of sclerosis involves the joints; on the penis (sclerodermia annularis) in the form of a ring in the head groove; on the scalp, often with transition to the skin of the forehead and nose, accompanied by pronounced atrophy of not only the skin, but also the underlying tissues, which gives them a resemblance to a scar after a saber strike (sclerodermia en coup de sabre).

White spot disease (lichen sclerosus et atrophicans)- a teardrop-shaped variant of limited scleroderma, but this is not generally accepted. It is characterized by small atrophic lesions of a whitish color with thin folded atrophied skin surrounded by a narrow erythematous rim. Small lesions are grouped, forming lesions up to 10 cm in diameter or more.

Atrophoderma idiopathic Pasini-Pierini manifests itself in several lesions, located mainly on the torso, without or with slight compaction, pinkish-bluish color, which is then replaced by a brownish tint and barely noticeable surface atrophy. At the same time, various forms of limited scleroderma can exist.

Signs systemic scleroderma

Systemic (diffuse) scleroderma manifested by the defeat of everything skin(diffuse scleroderma), which becomes edematous, dense, inactive, waxy, or in the form of acrosclerosis with the most significant changes in the skin of the face and distal parts of the extremities, mainly the upper. The process also has 3 stages - edema, sclerosis and atrophy. The swelling begins and is more pronounced on the torso, from where it then spreads to other areas of the body.

Gradually, with the symptoms of scleroderma of this form, compaction develops. The face becomes amicable, resembles a mask, and purse-shaped folds form around the mouth. The tongue protrudes with difficulty due to sclerosis of the frenulum. There are difficulties when swallowing food (narrowing of the esophagus). This kind of lesion can be localized on the genitals, in large skin folds, on the body. Thickened skin over the joints makes it difficult to move the fingers (sclerodacty) and is easily injured, which can lead to difficult-to-heal ulcers.

The stage of swelling and hardening is replaced by atrophy of the skin and muscles. Consequence atrophic changes skin may be poikiloderma (with telangiectasia, interspersed with areas of hyper- and depigmentation and atrophy), hair loss. A significant proportion of patients (up to 25%) experience deposition of calcium salts in the skin and subcutaneous tissue (Tibierge-Weissenbach syndrome), Raynaud's phenomenon. Of the internal organs with symptoms of scleroderma of this form, they are predominantly affected digestive tract, especially the esophagus, but also the lungs, heart and kidneys.

How to treat scleroderma using traditional methods?

Treatment should be comprehensive and aimed at suppressing the activity of immune and autoimmune reactions, intensive collagen formation, as well as normalizing the function of some of the most affected organs and systems. Drug therapy includes corticosteroid, immunosuppressive, non-steroidal, anti-inflammatory drugs, as well as vasodilators and other drugs.

How to treat systemic scleroderma?

At systemic scleroderma on early stage Prescribe Penicillin 1–1.5 million units per day for 24 days, Lidase 64 units intramuscularly every other day, for a course of 12–15 injections (4–6 courses), prescribe antihistamines, antiserotonin drugs (Diazolin, Peritol), and also - improving microcirculation and tissue metabolism (Teonikol, Reserpine, Pentoxifylline, Cinnarizine) for 2-3 weeks.

After the main course of treatment, Prodectin or Parmidin are prescribed for a month, Andekalin 10–40 units intramuscularly (for 2–4 weeks), vitamins, especially A and E, biogenic preparations (aloe, vitreous, ATP, etc.), Solcoseryl, Actovegin. With pronounced activity of the process and significant immune disorders, scleroderma should be treated using hyperbaric oxygenation, plasmapheresis, hemosorption, and corticosteroids. Usually in small doses (Prednisolone 20-40 mg every other day with a gradual reduction in dose after achieving a clinical effect to maintenance).

Nonsteroidal anti-inflammatory drugs and cytostatics are also used (for example, Azathioprine or Cyclophosphamide 100–150 mg per day, Methyldopa 0.5–2.0 g per day).

One of the basic therapy drugs is Cuprenil. Treatment in a hospital begins with a small dose of 0.15–0.3 g per day, which is increased weekly by 0.15 g to daily dose 1–2 g. The drug is used at this dose for several months (about 6 on average), then it is reduced by 0.15 g per week to a maintenance dose of 0.3–0.6 g, which is continued for a long time, at least of the year.

For Raynaud's syndrome, calcium antagonists (for example, nifedipine) are indicated; for calcinosis, disodium ethylenediamine tetraacetic acid (EDTA) is indicated. Physiotherapeutic procedures (warm baths, paraffin, mud), gymnastics, massage are useful.

How to treat limited scleroderma?

At limited scleroderma Repeated courses of Penicillin in combination with Lidaza, 64 units intramuscularly daily or every other day, up to 20 injections, and vasoactive drugs are prescribed. In some patients, Lelagil (0.25 g once a day) and small doses of Cuprenil (0.45 g per day), prescribed for several months, are effective. It is recommended to lubricate the lesions with corticosteroid ointments (Hydrocortisone, Prednisolone), Solcoseryl, Indovazin, Heparin, Indomethacin ointment, Troxevasin gel.

This form of carnitine chloride (5 ml of 20% solution) 2 times a day orally for 35–45 days, with repeated courses after 1–4 months, has been noted to be useful in the treatment of scleroderma; in the interval between courses, it is appropriate to prescribe Dipromonium 0.02 g 3 times a day, 30–40 days): Diucifon (0.1–2 g per day orally in 5-day cycles with one-day breaks, 4–6 cycles per course); Unithiol (5 ml of 5% solution once a day, 5–20 injections per course; Tactivin or Timoptin (at the rate of 5–10 mcg per 1 kg of body weight, subcutaneously on days 1.5, 10, 15 and 21, per course 500–550 mcg); Tigazon (at the rate of 1 mg per 1 kg of body weight for 2–3 weeks, then 0.6–0.8 mg per 1 kg of body weight for 4 weeks with a gradual reduction in dose to 25 mg per day and discontinuation of the drug approximately within 2 weeks).

Treatment of linear scleroderma

At linear scleroderma Phenytoin is prescribed (initially 0.1 g 2-3 times a day, then 0.1 g per day for a long time), antimalarial drugs (for example, Delagil 0.25 g per day). There is data on positive action radon baths, Dimexide (in pure form or in a 30–90% solution, including with corticosteroids, for example Dexamethasone at 0.05% concentration).

In the treatment of scleroderma, it is advisable to use a 20% solution of Lidase or Ronidase and proteolytic enzymes on the lesions using phonophoresis. It is possible to use diadynamic Bernard currents, local barotherapy and vacuum therapy, trypsin and chymotrypsin (in the form intramuscular injections or introduced using ultrasound), laser beams (helium-neon or infrared), ultra-high frequency electromagnetic field alternating with iodide-bromine baths, electro- and phonophoresis of Ronidase, Lidase, Potassium Iodide, Ichthyol; applications of Paraffin, Ozocerite, therapeutic mud, Naftalan.

For supporting therapeutic effect important dispensary observation; repeated sanatorium treatment at balneological and mud resorts, massage, therapeutic exercises; 2-3 courses of Lidaza for a year, biogenic drugs, alternating them with medicines, improving microcirculation, vitamins, in combination (if necessary) with external agents (Dimexide, Hydrocortisone ointment, electrophoresis with Lidase).

Physiotherapy for scleroderma

Physical methods are aimed at reducing the immune response (immunosuppressive methods), relieving inflammation (anti-inflammatory methods), restoring connective tissue metabolism (fibromodulating methods) and microcirculation disorders (vasodilating methods). These tasks help to realize following methods physiotherapy:

Immunosuppressive methods: aerocryotherapy, drug electrophoresis immunosuppressants, nitrogen baths.

Anti-inflammatory treatment methods: DMV therapy on the adrenal gland area, hydrocortisone ultraphonophoresis.

Fibromodulating methods: peloid therapy, hydrogen sulfide, radon baths.

Vasodilating methods: paraffin therapy, ozokerite therapy.

Contraindications to treatment: acute course diseases with a high degree of activity, severe damage to the heart, kidneys, peripheral and central nervous system.

Sanatorium-resort method of scleroderma therapy

Patients with systemic scleroderma with subacute and chronic course with minimal activity process are sent to balneotherapy resorts with hydrogen sulfide waters (Eysk, Sergievskie Mineral water, Pyatigorsk, Sochi, Belokurikha, Truskavets, Bakirovo, Goryachy Klyuch, New Klyuchi, Ust-Kachka, Maple Mountain, Khilovo, Argman, Surakhany, Chimion, Baldone, Shikhovo).

Contraindications to spa treatment of scleroderma are:

acute course of the process,

high degree of activity,

severe damage to internal organs.

Physioprophylaxis is aimed at suppressing intense collagen formation (fibromodulating methods), the activity of immune and autoimmune reactions (immunosuppressive methods), as well as mobilizing protective forces body and hardening (catabolic methods).

Folk remedies and recipes for scleroderma

Before scleroderma is treated, it is necessary to be diagnosed in a hospital because incorrect treatment may lead to complications. Drug treatment can be supplemented with folk remedies, but remember that it is only a supplement, not a replacement.

You can use a compress. To do this, you need to bake a small onion in the oven, then chop it and add a teaspoon of honey and two tablespoons of kefir. Mix thoroughly and apply a compress at night four times a week.

One of the methods - herbal decoction. You need to mix lungwort, knotweed and horsetail. Grind everything and pour one tablespoon with a glass of water and put on water bath for 15 minutes. Leave for half an hour, after which you can take it. The schedule is three times a day, a third of a glass, half an hour before meals or an hour after.

If complications arise during scleroderma, the following folk remedy will help. Collect leaves peppermint, lingonberries, plantain, raspberries, medicinal clover, meadow geranium, St. John's wort, bird knotweed, yarrow, golden rod, wormwood, fireweed, dandelion roots, chamomile, sandy immortelle and meadow clover.

Some of these ingredients can be bought at the pharmacy, some can be assembled yourself. Mix all herbs in equal quantities, grind, then pour two tablespoons of herbal powder into a liter of boiling water and leave to steep overnight in a thermos. In the morning, strain the infusion and drink a quarter glass three times a day half an hour before meals. The course lasts three months.

Herbal medicine can offer you many recipes, but before using them, be sure to consult your doctor.

Causes of scleroderma

The causes of scleroderma are usually hypothermia, various infections of the nervous system, and industrial vibration. All this contributes to changes in the walls of blood vessels, as a result of which they become denser and lose elasticity, which can lead to closure of the lumen small vessels. All these changes disrupt the blood supply to tissues and organs. Scleroderma may also have a genetic predisposition.

Predisposing and provoking factors for scleroderma may include:

hypothermia,

sharp or chronic infections,

sensitization,

endocrine dysfunction (hypoestrogenism, hypocortisolism).

The main mechanism for the development of scleroderma lies in the disruption of collagen synthesis and metabolism, which is confirmed by increased activity fibroblasts in tissue culture, increased collagen production in the active phase of the disease, high excretion of hydroxyproline. Intense production of immature collagen by fibroblasts leads to disturbances in the microvasculature. This is facilitated by neuromuscular dysfunction, defects of the immune system, confirmed by the presence of autoantibodies (antinuclear, anti-centromere to RNA, DNA, etc.), immune complexes, and emerging immunodeficiency with signs of cell-mediated hypersensitivity.

In the development of scleroderma, the participation of histamine and serotonin in the formation of edema and microcirculatory disorders, the influence of increased content of acidic mucopolysaccharides in the dermis on connective tissue sclerosis, the role of hereditary factors, as evidenced by family cases, the association of the disease with antigens of the HLA system (AL, B8, B18, B27, Bw40, DRI, DR5).

If we translate the term “scleroderma” literally, it turns out that this name hides a disease in which the skin becomes sclerotic, that is, thickens, loses its original structure, and the nerve endings inside it die.

Focal scleroderma– a pathology belonging to the class of systemic connective tissue (this also includes lupus erythematosus, Sjögren’s syndrome and some others). Unlike systemic scleroderma, in the case of the development of this subtype, internal organs practically do not suffer. Also, this form of pathology has a better response to treatment and may even disappear completely.

The essence of pathology

With focal scleroderma, the “matter” suffers, from which the supporting frames of all organs are built, ligaments, cartilage, tendons, joint capsules, intercellular “layers” and fatty “seals” are formed. Although connective tissue may have different condition(solid, fibrous or gel-like), the principle of its structure and the functions performed are approximately the same.

Human skin is also partially composed of connective tissue. Her inner layer, dermis, allows us not to burn from ultraviolet rays, do not get blood poisoning due to the inevitable ingress of microbes from the air, and do not become covered with ulcers when in contact with aggressive substances. It is the dermis that determines the youth or old age of our skin, makes it possible to make movements in the joints or show our emotions on the face, without then having to deal with long-term recovery appearance from folds and cracks.

The dermis consists of:

individual cells, some of which are responsible for the formation of local immunity, others for the formation of fibrils and amorphous substance between them;
fibers (fibrils), which provide the skin with elasticity and tone;
vessels;
nerve endings.

Between these components lies a gel-like “filler” - the previously mentioned amorphous substance, which ensures the skin’s ability to immediately return to its original position after the work of facial or skeletal muscles.

There may be situations when immune cells located in the dermis, begin to perceive some other part of it as a foreign structure. Then they begin to produce antibodies here that attack fibroblast cells that synthesize dermal fibers. Moreover, this does not happen everywhere, but in limited areas.

The result of an immune attack is increased production fibroblasts of one of the fibers - collagen. Appearing in excess, it makes the skin dense and rough. It also “entwines” the vessels inside the affected areas of the dermis, which is why the latter begin to suffer from a lack of oxygen and nutrients. This is what focal scleroderma is.

Dangers of the disease

Existing in a limited area of skin and being promptly diagnosed and treated, the pathology does not pose a threat to life. It only contributes to the formation of a cosmetic defect, which can be eliminated by dermatological and cosmetological methods. But how dangerous is focal scleroderma if you don’t pay attention to it?

This pathology can:

cause the appearance of dark areas on the skin surface;
provoke development vascular networks(telangiectasia);
lead to chronic syndrome Raynaud's, associated with impaired local microcirculation. It manifests itself in the fact that in the cold a person begins to experience pain in the fingers and toes; at the same time, the skin of these areas sharply turns pale. When warming up, the pain goes away, the fingers first turn purple, then acquire a crimson tint;
be complicated by calcification, when small and painless “nodules” appear under the skin, having a rocky density. These are deposits of calcium salts;
spread to extended areas of the skin. In this case, collagen fibers compress the sweat and sebaceous glands located in the dermis, and this leads to disruption of the body’s thermoregulation;
go into, causing damage to internal organs: the esophagus, heart, eyes and others.

Therefore, if you find symptoms of pathology (they will be described below), contact a rheumatologist to find out how it is treated.

Who gets sick more often

Scleroderma, which has only focal manifestations, is more often found in females. Girls get it three times more often than boys; pathology can be detected even in newborns, and by the age of 40, women make up ¾ of all patients with scleroderma. The “love” of scleroderma for the fair sex is connected with the fact that:

cellular immunity(these are the cells that themselves, not with the help of antibodies, destroy foreign agents) is less active in women;
the humoral (antibody-mediated) component of immunity has increased activity;
female hormones have a pronounced effect on the functioning of microcirculation vessels in the dermis of the skin.

Causes of the disease

The exact cause of the pathology is unknown. The most modern hypothesis states that focal scleroderma occurs as a sum of:

entry of infectious agents into the body. A significant role is attributed to the measles virus, viruses of the herpes group (herpes simplex, cytomegalovirus, Epstein-Barr virus), papillomatosis virus, as well as staphylococcal bacteria. There is an opinion that you can get scleroderma as a result of having scarlet fever, tonsillitis, or Lyme disease. Borrelia Burgdorferi DNA, causing disease Lyme, or antibodies to it, are observed in blood tests of most patients with focal scleroderma;
genetic factors. This is the carriage of certain receptors on immune cells-lymphocytes, which contribute to chronic course the above infections;
endocrine disorders or physiological conditions in which the hormonal background(abortion, pregnancy, menopause);
external environmental factors that most often trigger “dormant” scleroderma or aggravate the disease, which was previously hidden. These are: stress, hypothermia or overheating, excess ultraviolet rays, blood transfusion, trauma (especially traumatic brain injury).

It is also believed that the triggering factor for the appearance of scleroderma is tumors present in the body.

The opinion of domestic scientists led by L.A. Bolotnaya, who studied changes in skin cells that appear during focal scleroderma, is also important. They believe that the development of this pathology can be triggered by a decrease in magnesium content in the blood, which causes calcium to accumulate in red blood cells and disrupt the functioning of a group of enzymes.

Who is at risk

Women aged 20-50 years are most at risk of developing focal scleroderma, but men are also at risk:

blacks;
those who already have other systemic connective tissue diseases;
whose relatives suffered from one of the systemic connective tissue pathologies (lupus erythematosus, rheumatoid arthritis, dermatomyositis);
workers open markets and those people who sell goods from street stalls in winter;
builders;
persons who are forced to frequently take refrigerated goods from freezers;
those who guard warehouses food products, as well as representatives of other professions who are often forced to become hypothermic or expose their hands to chemical mixtures.

Classification

Focal scleroderma can be:

1. Plaque (discoid). It has its own division into:

superficial;
deep (nodular);
indurative-atrophic;
bullous (a bulla is a large bubble filled with fluid);
generalized (throughout the body).

2. Linear:

as a “strike with a saber”;
strip-shaped;
zosteriformis (similar to or chickenpox).

3. White spot disease.

4. Idiopathic, Pasini-Pierini, atrophy of the dermis.

How does the disease manifest itself?

The first symptoms of focal scleroderma appear after Raynaud's syndrome has existed for several years. Also, specific scleroderma signs can be preceded by peeling of the skin of the palms and feet, the appearance spider veins in the buccal areas (if the outbreak appears on the face).

The first symptom of focal scleroderma is the appearance of a lesion:

looks like a ring;
small sizes;
violet-red color.

Further, such a lesion changes and becomes yellow-white, shiny, and cooler to the touch. The “rim” around the perimeter still remains, but the hair begins to fall out and the lines characteristic of the skin disappear (this means that the capillaries are no longer functioning well here). The affected skin surface cannot be folded; she does not sweat and does not become covered with sebaceous gland secretions, even if the surrounding skin is oily.

Gradually, the purple “ring” disappears, the whitish area is pressed in and is located below the healthy skin. At this stage, it is not tense, but soft and pliable to the touch.

The second main type of pathology is linear scleroderma. It occurs most often in children and young women. The difference between linear scleroderma and plaque scleroderma is visible to the naked eye. This:

a strip of yellowish-white skin;
shaped like a stripe from a saber strike;
most often located on the torso and face;
may cause atrophy (thinning, paleness, hair loss) on half of the face. Both the left and right half of the face may be affected. The skin on the affected half becomes bluish or yellowish, first thickens, and then atrophies, and the skin also undergoes atrophy. subcutaneous tissue, and muscles. Facial expressions in the affected area become inaccessible; it may seem that the skin is “hanging” on the bones of the skull;
may occur on the labia, where it looks like whitish-pearl-colored lesions of uneven shape, surrounded by a bluish “rim”.

Pasini-Pierini disease is a series of purple-lilac spots with a diameter of about 10 cm or more. Their outlines are irregular, and they are most often located on the back.

The transition from a focal form of scleroderma to a systemic one can be suspected based on the following criteria:

a person fell ill either before the age of 20, or after 50;
there is either a linear form of pathology, or there are many plaques;
foci of scleroderma are located either on the face or in the area of the joints of the legs and arms;
In a blood test for an immunogram, cellular immunity is impaired, the composition of immunoglobulins and antibodies to lymphocytes is changed.

Diagnostics

With focal scleroderma, antibodies are detected in the blood against cell nuclei, the enzymes topoisomerase I and RNA polymerase I and II, centromeres (regions of chromosomes in which division will occur during nuclear division). But the diagnosis is not made by these antibodies, or even by the presence of Scl70 antibodies in the blood. It is established according to a specific picture, which is seen under a microscope by a histologist when studying an area of “sick” skin taken through a biopsy.

Treatment

First, we will answer the question of whether focal scleroderma is curable, in the affirmative. Before skin atrophy occurs over a large area, the disease can be stopped with several courses of drugs for local and systemic use.

Treatment of focal scleroderma begins with the following systemic medications:

Antibiotics of the penicillin group. They must be drunk during the first 3 courses.
Injections of drugs that improve vascular function. First of all, these are products based on nicotinic acid, dilating capillaries, reducing their thrombosis and formation in large vessels cholesterol plaques. The second are drugs that prevent platelets from “clogging” the capillaries: Trental.
Calcium current blockers (Corinfar, Cinnarizine). These medications relax the smooth muscles of blood vessels, improve the penetration of necessary substances from the vessels into the cells of the skin, muscles and heart.

Also used for focal linear scleroderma local treatment ointments. It is recommended to apply not one, but several of these local funds, having different directions, at different times of the day. So, the following are required for use:

Solcoseryl or Actovegin are drugs that improve the utilization of oxygen by skin cells, which leads to the normalization of its structure;
heparin, which reduces thrombus formation in blood vessels;
Egallohit cream. This is a preparation based on green tea, which, with the help of the catechins it contains, will trigger the formation of new blood vessels at the initial stage of the disease, and in the end it will suppress this process. It also prevents the formation increased amount collagen, has anti-inflammatory and antioxidant effects;
Troxevasin gel, which strengthens blood vessels;
Butadione is an anti-inflammatory drug.

The effect is provided by physiotherapeutic methods (phonophoresis with lidase preparations, paraffin applications, radon and mud baths), massage, hyperbaric oxygen therapy, plasmapheresis, autohemotherapy.

Traditional methods

Treatment with folk remedies can complement scleroderma therapy. This:

compress with aloe juice applied to gauze;
a compress of dry wormwood mixed with petroleum jelly or wormwood juice mixed 1:5 with pork fat;
ointment from tarragon mixed 1:5 with interior fat. The fat should be melted in a water bath, and together with the tarragon it should be simmered in the oven for about 6 hours;
taken orally, 100 ml per day, decoctions of St. John's wort, motherwort, calendula, hawthorn, red clover.

This is the name of one of the diseases that affects connective tissue.

As a rule, for the development of this disease, problems in the functioning of the immune system that are present from birth, so-called autoimmune disorders, are necessary.

The immediate impetus for the emergence may be mechanical damage tissue, inflammation allergic nature or hypothermia.

Women are more susceptible to this disease.

Symptom of scleroderma is the appearance of spots with clear, rounded outlines. The size of the spots is approximately the size of a palm, the color is pinkish-blue. The spots develop into ivory-colored plaques that are hard to the touch (almost like wood). The surface of the plaques is smooth, shiny, while they grow, they are surrounded by a ring lilac color. As months and sometimes years pass, the plaques lose their hardness and become white-colored skin scars. There is a variant of the disease in which the plaques look like stripes, it is called ribbon-like scleroderma. Wherein painful sensations are missing.

Treatment of scleroderma with folk remedies

Homeopathy remedies are often used, such as Calcarea fluorica 12, which is taken daily before meals, 5-8 grains, placing them under the tongue, or Silicia, diluted to at least 12D. Adaptogen plants can help well - Leuzea, aralia, Rhodiola and ginseng. To do this, you need to prepare tinctures with alcohol from them. For every two kilograms of patient weight, one drop of tincture is required. For children under 14 years of age, a drop of tincture corresponds to each year of life. The tincture is taken three times a day, treatment lasts from one and a half to three months. Treatment with tincture is carried out during remission; it cannot be carried out during an exacerbation. In spring and autumn it should be carried out preventive treatment one and a half month courses.

A certain positive effect is obtained from the use of dandelion officinalis (root), potbellied high (root). These plants are also taken orally in the form of aqueous decoctions. Aqueous decoctions are prepared at the rate of a tablespoon per glass of water. 15 minutes in a water bath, stand for 30 minutes, strain, bring to the original volume. Take 1/3 glass 3 times a day before meals 30 minutes.

As an external treatment, we can recommend an ointment based on tarragon wormwood. The ointment is prepared as follows: heat in a water bath visceral fat and throw dry tarragon into it at the rate of 1 part raw material to 5 parts fat. Simmer in the oven for 5-6 hours. Strain, let it cool and put it in the refrigerator, where it is all then stored. Apply the ointment externally to the affected areas of the skin 3 times a day for 2-3 months.

Goldenrod, also known as goldenrod, is contraindicated for patients with scleroderma.

Tags: traditional treatment scleroderma, scleroderma folk remedies, scleroderma treatment with folk remedies.

For scleroderma, it is necessary to use products that can
connect fabrics. The composition of such products includes silicic acid and
silicon. These substances are found in lungwort, horsetail and
knotweed Silicon is a basic tool that is very important
for the body's immune system and connective tissue development.

To prepare a folk remedy to help cure
scleroderma, take in equal parts knotweed, horsetail and
lungwort. Pour one tablespoon of this mixture into a glass of water, and
keep in a water bath for fifteen minutes. Then give
let it brew for half an hour, and then take the third portion
glass half an hour before meals, three times a day. You can do the same after eating
after one hour.

Due to the occurrence of this disease, complications arise in the
heart. As a result, diseases such as arrhythmia,
heart failure and pulmonary hypertension. Will help you cope
with this disease, a decoction of cyanosis and adonis. Take the same
amount of crushed cyanosis and adonis herbs, mix and one
Brew a tablespoon of the collection with boiling water - half a liter in a thermos.
Let the decoction steep for eight hours. Use this
composition: one fourth of a glass three times a day per hour -
two hours after eating.

If you have a pulmonary pathology, then a composition of knotweed, lungwort and
horsetail, you need to add one teaspoon of wild rosemary.

For kidney pathology, add one teaspoon to the same composition
lingonberry leaf and bearberry. Don't forget that when adding these
herbs in each case you need to add half a glass of water.

If blood appears in your urine, add one teaspoon
a spoonful of stinging nettle and yarrow. Remember that liquid also
need to increase by half a glass.

If the gastrointestinal tract is disrupted, add one
a teaspoon of bitter wormwood and three-leaf watch.

For joint pain due to scleroderma, take
one tablespoon of meadowsweet herb (powder), and pour it into boiling water
- half a liter, boil for ten minutes. Then pour into
this composition is a decoction of stinging nettle - one tablespoon
of this substance, and leave for two hours. Drink the composition according to
half a glass twice a day.

If you feel an exacerbation of this disease due to
psychological and emotional stress, the following will help you
folk method: take one tablespoon of skullcap roots
Baikal, pre-crushed, pour half a liter of it
boiling water and simmer for ten minutes. Then give the composition
leave in a thermos for six hours and take one at a time
third glass three times a day, after meals.

For complications of scleroderma and various pathologies, will help
the following recipe: Take lingonberry, raspberry, plantain leaves,
peppermint, herb medicinal clover, perforated
St. John's wort, meadow geranium, knotweed, golden rod,
yarrow, fireweed, wormwood, dandelion roots,
flowers of sandy immortelle, chamomile, meadow clover.
All ingredients are taken in equal parts and crushed. Two dining rooms
spoons of the collection pour one liter of boiling water in a thermos and leave in
for one night. In the morning, strain the mixture and take one at a time
a quarter of a glass three times a day half an hour before meals.
Treat this way for three months.

Then take a break for fourteen days and change the herbs from
which you will make a decoction of. The new collection includes: raspberry leaves and
plantain, dandelion and burdock root, St. John's wort herb
perforatum, yarrow, meadow geranium, sweet clover
medicinal, fireweed, wormwood, as well as flowers
calendula and pharmaceutical chamomile. Take all ingredients equally and
prepare in the same way as stated above for the first
decoction

These decoctions must be treated at times when the disease is not
worsens, but on the contrary subsides.