Scleroderma
Question: My 33 year old son has scleroderma. He had surgery on his hand in 1996. The bones in his thumb were fused and other adjustments were made to increase mobility. At first things were much better, but now he has constant pain. He gets discouraged and depressed. How can we stop the pain?

Answer: I am not sure from your description as to the location of the pain. That is, is this a nerve compression problem, scarring from surgery, or changes due to scleroderma. A pain specialist or neurologist might be able to help you figure this one out.

Scleroderma
Question: Please send me information for the diagnosis of scleroderma.

Answer: Scleroderma is also referred to as sytemic sclerosis. This is a disease with unknown cause which is grouped in the category of connective tissue diseases. It is thought to be a disorder of the immune system "attacking" ones own connective tissues. It usually affects multiple organs in the body with thickening or fibrosis. Women are affected about three times more often than men and the disease is usually seen starting at age thirty-and then more frequently with age. The skin becomes thickened and leathery the Gl tract thickens and motility is a problem-especially the esophagus, thickening of the renal system can cause renal failuse, thickening of the lung tissue-respiratory difficulties, and thickening of the heart muscle-heart failure. The course of this disease varies a great deal. Some patients with only minor non-progressive problems, others with rapidly progressive multi-organ failure. Drugs don't seem especially effective although d-penicillamine has been used and steroids are sometimes used for treatment of a specific organ. Diagnosis of this disease is usually by the characteristic clinical picture, although biopsy is sometimes helpful.
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