Rheumatology

Systemic sclerosis

Questions discussed in this category

In patients with diffuse scleroderma and symptomatic lower extremity venous insufficiency, would you recommend treatment with endovenous laser/ablation?

The patient has tried conservative measures with compression stockings.

1 Answer available

What are some important considerations for use of ACE inhibition in scleroderma renal crisis patients who require dialysis?

For example, is captopril dialyzable?

1 Answer available

How would you counsel a patient with systemic sclerosis who wants to consider microneedling on the face or other skin which is not clearly involved with scleroderma?

1 Answer available

What would be your recommendation for treatment of worsening lung disease in a patient with long-standing scleroderma after long-term mycophenolate therapy which is no longer an option due to side effect/intolerance?

3 Answers available

Would you continue belimumab in high risk lupus patients with overlapping scleroderma features with ILD who become pregnant and who are already on HCQ and azathioprine?

1 Answer available

Are there situations in which you treat calcinosis cutis that is not symptomatic for the patient?

Given the lack of efficacy of most treatment options, do you generally try to treat calcinosis cutis that is not bothering the patient even if it is q...

2 Answers available

How would you approach a patient with anti-scl70 ab positive sine scleroderma complicated by ILD who also has seropositive RA with active arthritis?

Arthritis did not respond to HCQ.

2 Answers available

How would you approach management of a patient with rapidly progressive systemic sclerosis with worsening skin disease, myositis, arthritis, dysphagia and failure to thrive developing within 6 months?

The patient is a young African American female of reproductive age with positive Fibrillarin antibody and nucleolar antibody. No ILD.

1 Answer available

How do you approach symptom control in a patient with diffuse cutaneous systemic sclerosis (dcSSc) and rapidly progressive skin disease?

Relatively newly diagnosed RNA Pol 3+ dcSSc with rapidly progressive skin involvement now on methotrexate 20mg/week and tocilizumab for concurrent inf...

1 Answer available

What are the principal clinical and laboratory findings that lead a community rheumatologist to refer patients with scleroderma and lupus to a tertiary care center?

1 Answer available

How would you manage a patient with diffuse Systemic Sclerosis who develops severe rapidly progressive calcinosis?

1 Answer available

What protective post-op measures do you recommend for a patient with scleroderma and a history of ILD, PH, Raynaud’s and digital ischemia undergoing cardiothoracic surgery?

1 Answer available

What is the approach to use of ACE inhibitors for suspected scleroderma renal crisis in patients with only mildly elevated BP and renal artery stenosis?

2 Answers available

For patients with scleroderma at high risk of renal crisis, would you feel comfortable giving corticosteroids as pre-medication for rituximab?

1 Answer available

Is there a role for systemic therapy for a patient with scleroderma sine sclerosis, with esophageal strictures and Raynaud’s syndrome, but no pulmonary involvement?

1 Answer available

What treatment regimen for UVA-1 have you found most helpful in treating sclerotic diseases (e.g. morphea, scleroderma)?

4 Answers available

Is morphea, cutaneous scleroderma, with no organ involvement a contraindication for radiation in early stage breast cancer as part of breast conservation therapy?

3 Answers available

In a patient with history of scleroderma renal crisis resulting in ESRD, would you recommend using steroids for when needed?

1 Answer available

How do you manage calcium and vitamin D replacement in scleroderma and myositis patients with dysphagia and malabsorption?

1 Answer available

Would you consider rituximab in a patient with severe GI dysmotility caused by scleroderma?

2 Answers available

Do you recommend treatment of worsening skin thickening with Limited Scleroderma +ANA+centromere and if so with what agent would you use?

(Only associated with mild PAH(PAP 38) and with esophageal dysmotility as well.)

2 Answers available

How common are nasal telangiectasia in patients with systemic sclerosis?

Patient with pulmonary hypertension (mixed group 1, 2, 3), COPD, HFpEF, Raynaud’s phenomenon, UCTD (ANA, PM-Scl, SSA-52kd), and recurrent severe...

1 Answer available

What is your approach towards initial regimen and tapering of mycophenolate in scleroderma?

Does your approach differ if treating more ILD versus cutaneous disease?

2 Answers available

How do you specifically counsel patients on conservative measures such as hand warming in the treatment of SSc associated digital ulceration?

In addition to the usual pharmcotherapy (CCBs, etc.)

1 Answer available

What treatment options do you recommend to patients with microstomia secondary to scleroderma?

Have you tried hyaluronidase?

2 Answers available

How do you manage severe Raynaud's phenomenon with ulceration in scleroderma patients that is refractory to oral agents (CCBs, PDEis, ARBs, and ERAs)?

2 Answers available

Is there any role of sympathectomy in Raynaud’s disease?

2 Answers available

When is the index of suspicion high for paraneoplastic systemic sclerosis in terms of clinical and serological presentation and how will you work it up?

Does it mirror the same approach as SSc without malignancy? Do patients with paraneoplastic SSc present atypically (without usual serologies or featur...

1 Answer available

How do you monitor a patient with scleroderma during pregnancy?

1 Answer available

How would you escalate therapy beyond MMF in a patient with rapidly progressive SSc-ILD?

When would you consider referral for lung transplant?

2 Answers available

In the absence of lung disease, do you prefer methotrexate or mycophenolate mofetil in the initial treatment of cutaneous-only manifestations in systemic sclerosis?

2 Answers available

How do you mitigate the risk of renal crisis from corticosteroids in a patient with UCTD?

1 Answer available

Is there a role for cyclophosphamide in refractory digital ischemia in patients with scleroderma?

1 Answer available