SYSTEMIC-SCLEROSIS (SCLERODERMA) - CLINICAL MANAGEMENT OF ITS MAJOR COMPLICATIONS

Systemic sclerosis (scleroderma) is a disease of unknown cause whose p athogenesis involves interaction between the vasculature, the immune s ystem, and connective tissue cells. Although specific therapy awaits a better understanding of its pathogenesis, proper management may enhan ce not only the duration, but the quality of life for most scleroderma patients. Presently, controlled prospective trials of therapeutic age nts are lacking. Published reports of drug therapy for skin, kidney, c ardiac, pulmonary, and gastrointestinal complications, as well as mana gement of Raynaud's phenomenon, are critically reviewed in this articl e, and the authors' approach to management of difficult clinical probl ems is presented.