Management overview for systemic sclerosis

Note: There is no specific treatment for systemic sclerosis and management focuses on actively screening for, and managing, complications.

There is no specific treatment for systemic sclerosis. Management focuses on actively screening for, and managing, complications. It is best undertaken using a multidisciplinary approach with specialist involvement. Physiotherapists and other allied health professionals play an important role in the management of people with systemic sclerosis.

Management for the clinical symptoms shared by systemic sclerosis and other inflammatory connective tissue diseases is found in the following topics:

Note: Beware of using systemic corticosteroids in people with systemic sclerosis as they can precipitate accelerated hypertension and scleroderma renal crisis.

An important consideration in management for people with systemic sclerosis is that systemic corticosteroid use (for any condition) can precipitate accelerated hypertension and acute kidney failure, which together constitute scleroderma renal crisis. Scleroderma renal crisis is a medical emergency; see Management for scleroderma renal crisis.

If people with systemic sclerosis require low-dose oral corticosteroids for relief of symptoms (eg arthralgias, severe pruritis, tenosynovitis in the hands) or for a different condition (eg asthma), avoid doses of prednisolone (or prednisone) of more than 10 mg daily. If oral corticosteroids are necessary, try to use the lowest dose for the shortest duration. For the management of symptoms in systemic sclerosis, the usual dosage of oral corticosteroids is:

prednisolone (or prednisone) 5 to 10 mg orally, daily. prednis ol one prednis(ol)one prednis(ol)one

Note: Avoid prednisolone (or prednisone) doses of more than 10 mg daily in patients with systemic sclerosis because there is a risk of precipitating scleroderma renal crisis.