Systemic sclerosis

Singapore Med J. 1992 Apr;33(2):189-92.


Systemic Sclerosis is a multisystemic disease characterized by sclerosis of the skin and visceral organs, vasculopathy (Raynaud's phenomenon) and autoantibodies. The criteria for the classification of the disease requires either proximal scleroderma (major criteria) or the presence of 2 of the 3 minor features namely sclerodactyly, digital pitting scars and bibasilar pulmonary fibrosis. There are 3 subsets of this condition--diffuse variant, limited variant (CREST syndrome) and Overlap Syndrome (where patients have features of other rheumatic diseases). There are localized forms of scleroderma and pseudoscleroderma states. The presenting features of Systemic Sclerosis are usually Raynaud's, skin changes and arthralgia. Systemic complaints like breathlessness, dyspepsia, etc depending on the organ involved may be present. Management starts with patient education regarding the disease, skin care, exercises and regular medical check-up. There is no miracle cure but much can be done to improve the quality of life of the patient. Nifedepine and other drugs may improve Raynaud's phenomenon. Drugs can be used to treat other complications. Various medication have been tested as disease modifying drugs for scleroderma. These include drugs which inhibit collagen like D-penicillamine, colchicine, and immunosupressive drugs like cyclosporin. Ketotifen, a mast cell stabilizer has been reported to be effective in scleroderma. As it is a relatively safe drug, clinical trials are underway.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Comorbidity
  • Cyclosporine / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interferon-gamma / therapeutic use
  • Male
  • Prognosis
  • Raynaud Disease / diagnosis
  • Raynaud Disease / drug therapy
  • Scleroderma, Systemic / diagnosis*
  • Scleroderma, Systemic / drug therapy
  • Scleroderma, Systemic / epidemiology
  • Singapore / epidemiology


  • Immunosuppressive Agents
  • Interferon-gamma
  • Cyclosporine