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

There really have not been adequate trials in patients with limited cutaneous scleroderma as far as the effectiveness of medication for 'worsening' skin thickening. In this situation, it is not clear since the patient likely has a long-standing disease, really has worse skin thickening and where is ...

I agree with Dr. @Dr. First Last completely. This patient subset almost always has skin tightness only in the fingers. I have seen new skin tightness in the distal LE in the context of development of PH but this is likely either edema alone or a component of skin tightness developing secondary to th...