Scleroderma

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What happens when your body’s own tissue becomes your worst enemy?

When you have scleroderma, that’s what happens. Usually, your body’s immune system fights outside threats like bacteria, viruses and fungi. But sometimes, things backfire. And your body attacks itself. This rare autoimmune condition causes your skin and other body parts to thicken and harden into scar tissue.

So, when you hear you may have scleroderma, you’ll want to find healthcare providers with lots of experience treating it. At Cleveland Clinic, our scleroderma experts are here to help you manage your symptoms, reduce flare-ups and damage — and live more comfortably.

Why Choose Cleveland Clinic for Scleroderma Care?

Personalized care:

No one’s scleroderma looks or progresses the same way. That’s why we listen to your concerns, answer your questions and take the time to understand your symptoms. We use what we learn to make sure you get the most personalized care and the best possible treatment results.

Comprehensive treatment:

Your provider may recommend a combination of therapies to manage scleroderma symptoms. Medications, physical therapy and lifestyle changes may reduce pain and help you move more comfortably. We’ll guide you through each step. Meet our team.

Skilled, collaborative providers:

Scleroderma affects your skin but can also damage your joints, lungs, digestive tract, kidneys and more. Our team-based approach to care means you’ll have providers from different specialties working together to plan and manage your treatment.

Virtual visits:

Cleveland Clinic’s virtual visits are an easy alternative to seeing your provider in person. You only need an internet connection and a smartphone, computer or tablet to connect with your provider online, from the comfort of home.

National recognition:

Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.

Diagnosing Scleroderma at Cleveland Clinic

Scleroderma is an autoimmune rheumatologic disease that turns normal tissue into scar tissue. Your immune system triggers cells to make too much of a protein called collagen. This collagen gets into your skin and organs. And they harden and thicken like scar tissue.

Diagnosing scleroderma can be tricky because it has different forms and affects many body parts, including your joints. Because of this, it can be mistaken for other autoimmune conditions like rheumatoid arthritis or lupus.

Types of scleroderma

Scleroderma has two forms — localized and systemic. Localized sclerodermais more common and affects only your skin. It can show up as waxy patches or streaks, usually, in just a few places. Sometimes, localized scleroderma gets better on its own without treatment.

Systemic sclerodermais less common. It affects many body areas and can become serious if left untreated. There are two types of systemic scleroderma — diffuse and limited. Diffuse scleroderma affects many different internal organs. It can affect how your kidneys, lungs, digestive system and heart work. And it can be serious and life-threatening.

Limited scleroderma is also known as CREST syndrome, which stands for different features of this condition:

Calcium deposits in your skin (calcinosis).
Raynaud’s phenomenon (secondary Raynaud’s syndrome).
Difficulty swallowing (esophageal dysmotility).
Tight skin on your fingers (sclerodactyly).
Red spots on your skin (telangiectasias).

Your kidneys aren’t usually affected by limited scleroderma. Later complications can include pulmonary hypertension. This can lead to right-sided heart failure.

If scleroderma has caused immune damage to your body’s moisture-producing glands, you might also have Sjögren’s syndrome (dry eyes and mouth).

What to expect at your first visit

At your first appointment, your provider will take time to get to know you. And they’ll ask you to share your story. Understanding what’s happening can help them make the correct diagnosis. They’ll want to know:

What symptoms are you having?
When did your symptoms start?
Have your symptoms been getting worse?
Are your symptoms affecting your life?
Have you been diagnosed with any other health conditions?
Do any family members have scleroderma or other autoimmune diseases?

During this visit, your provider will also do a physical exam. They’ll check for signs of scleroderma, particularly any thickened, hardened or discolored skin. They’ll also order tests to help confirm a diagnosis.

Testing for scleroderma

Several tests can help us better understand what type of scleroderma you may have and how severe it is. These tests include:

Blood tests: Check for antinuclear antibodies (that most people with scleroderma have) and signs of kidney damage.
Pulmonary function tests: Check how well your lungs work.
Chest imaging: Checks for lung scarring caused by scleroderma using a lung CT scan (computed tomography scan).
Electrocardiogram (EKG): Checks electrical activity in your heart.
Echocardiogram (Echo): Looks for scarring in your heart tissue.
Gastrointestinal tests: Check for scarring in your esophagus and walls of your intestines using upper endoscopy and esophageal manometry.

Meet Our Scleroderma Team

At Cleveland Clinic, we use a team-based approach to care. This means you’ll see providers from different specialties who’ll work together to make sure you stay at the center of your care. Depending on your needs, your team may include:

Providers Who Treat Scleroderma

Locations

Our healthcare providers see patients at convenient locations throughout Northeast Ohio, Florida and in London.

Treating Scleroderma at Cleveland Clinic

Once we get your test results back, your provider will go over them with you. And then they’ll work with you to build a highly personalized treatment plan. This plan will focus on the type of scleroderma you have, your symptoms and your recovery goals. Therapies could include:

Lifestyle changes

Sometimes, you can manage mild scleroderma with lifestyle changes. We may recommend:

Changing what and how you eat.
Exercise.
Joint and skin care.
Proper dental care.
Stress management.
Physical therapy.

Medications

Several medications can help manage severe symptoms, especially if scleroderma affects many of your organs. We may prescribe:

Antacids, proton pump inhibitors (also called PPIs, like Prevacid^®, Protonix^® or Nexium^®) or H2 receptor blockers (Pepcid^®) to treat heartburn and GERD.
Immunosuppresive drugs, such as mycophenolate mofetil (CellCept^®) or cyclophosphamide (Cytoxan^®) for lung scarring (pulmonary fibrosis) resulting from interstitial lung disease.
Various medications for pulmonary hypertension.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to relieve joint pain.
Topical gels or creams to help moisturize dry, hard skin or treat skin sores.
Various medications to treat Raynaud’s phenomenon and its symptoms.
Drugs to manage and treat scleroderma-related kidney disease.

Clinical trials

Your provider may suggest you participate in one of our clinical trials if other therapies aren’t working. Enrolling in a clinical trial lets you try new medications that aren’t widely available. Your provider will keep an eye on you to see if you have any side effects and if your symptoms improve.

Taking the Next Step

A scleroderma diagnosis is serious, but treatable. Cleveland Clinic’s expert healthcare providers can help you find the best ways — using the latest treatments — to manage your symptoms, so you can live an active, healthy and productive life.