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ULY CLINIC
ULY CLINIC
20 Oktoba 2026, 12:37:49
Systemic sclerosis (scleroderma)
20 Oktoba 2026, 12:37:49
Skin thickening (sclerodactyly), Raynaud's, digital ulcers, telangiectasia, calcinosis; reflux, dysphagia, malabsorption; ILD and pulmonary hypertension; renal crisis (hypertension, AKI); pericarditis, arrhythmias.
Investigations: ANA, anti-centromere, anti-Scl-70, anti-RNA polymerase III; creatinine, urinalysis, BP; chest X-ray, HRCT, echocardiogram. ACR/EULAR 2013 score 9 or more.
Management
Avoid cold, moisturise the skin, physiotherapy for hands and joints.
Raynaud's: A: nifedipine (PO, extended release) 20–120 mg once daily.
Reflux: A: omeprazole 20–40 mg, OR C: pantoprazole 40 mg, OR S: esomeprazole 20–40 mg once daily.
ILD: S: cyclophosphamide 500–1000 mg/m² IV every 4 weeks, OR S: mycophenolate mofetil 1–1.5 g every 12 hours (with pulmonology).
Renal crisis (emergency): C: enalapril 5–40 mg/day OR C: lisinopril 5–40 mg/day (with nephrology).
Skin and joints: S: methotrexate 15–25 mg weekly, OR S: azathioprine 1–2 mg/kg daily.