SKIN
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Skin
thickening
Hardening
and thickening of the skin give scleroderma its name (“hard skin.”) There are no
proven treatments as yet to prevent or alter the course of the skin changes in
scleroderma. Many medications and treatments are being tested. The skin
sometimes softens spontaneously over time.
Skin
ulcerations
Sores,
especially on the fingertips, are a common symptom of systemic scleroderma.
They may be very slow or difficult to heal because of poor circulation. These
sores or ulcerations may also occur on the knuckles, elbows, toes or other
sites of the body where the skin is especially tight or stretched. The affected
area should be kept warm to increase blood flow and carefully cleaned to avoid
infection. If an infection develops, it may help to soak the affected area in
warm water, apply an antiseptic such as Betadine® or use an antibiotic ointment.
Should these remedies prove unsuccessful in relieving the pain or infection of
ulcerated skin, your doctor may prescribe oral antibiotics or take other
measures.
Calcinosis
This
condition is characterized by deposits of calcium in the skin, which may be
painful. The calcium deposits may occur just below the skin surface in the form
of hard lumps or nodules. They may break through the skin, becoming visible as
chalky white material, and may become infected. Care should be taken not to
bump or injure affected areas. Warm-water soaks may be helpful. Antibiotics may
be prescribed to prevent or control infection. In severe cases, surgery to
remove calcium deposits may be required.
Telangiectasia
This
abnormality consists of the dilation of small blood vessels near the surface of
the skin, which become visible as small red spots, usually on the fingers,
palms, face and lips. The spots usually fade with pressure, but turn red again
when the pressure is released. These spots generally are not harmful. Special make-up
may be used to mask the spots or to reduce their visibility.
Dry
skin
Excessive
dryness of the skin may lead to skin breakdown and ulcerations. Excessive
bathing and hand washing should be avoided, and rubber gloves worn to avoid
direct contact with household detergents. Keeping the skin moist and
well-lubricated is important to avoid complications from dry skin. Bath oils
and moisturizing soaps are preferable to harsh soaps which dry out the skin.
Frequent use of moisturizing skin creams containing lanolin is advised. During
the winter months, a humidifier may help.
Itchy
skin
Pruritus,
or itchy skin, is caused by irritation in the skin from the underlying
inflammatory process associated with scleroderma. If moisturizing creams do not
work, your doctor may prescribe a topical cortisone cream to rub on the skin to
relieve itching. Antihistamines have been effective for some people.
Other
skin symptoms
There
may be a decrease in hair over affected areas of the skin, as well as a
decrease in the ability to sweat. In addition, there may be an increase in
pigment (which looks like a skin tan) or a spotty loss of pigment.