Scleroderma

Is a chronic disease of unknown etiology characterized by inflammatory, vascular, and fibrotic changes of the skin, internal organs (G.I. tract, esophagus, thyroid, kidney, heart, and lungs) and articular structures. It is also called Progressive Systemic Sclerosis (PSS). The skin thickening and restriction follows an idiopathic overproduction of collagen. The disease is highly individual in terms of severity and progression. Some patients may experience only skin changes and restrictions in the hands and face for decades before visceral or organ involvement begins. Others may rapidly develop generalized cutaneous thickening and often lethal internal organ disease. The full manifestation of the disease is known as the CREST Syndrome: Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactylia, and, Telangiectasia.

Scleroderma is seen in women four times as often as in men, and is rare in children. It is found worldwide but more rarely in Asia. The usual age of onset is around 20-40. Although the course of the disease is variable and unpredictable, it is characterized by a slowly progressing involvement of the skin and/or visceral organs. Remissions are rare but do occur. The disease is typically very gradual: 80% of patients will be alive after 2 years and 20% will be alive after 10 years. The disease is most severe in black women; in whites, men are often affected worse than women. The usual causes of death are renal, cardiac and/or lung complications. Symptoms Initial complaints include: Raynaud’s phenomenon, skin thickening of the fingers, swelling of the extremities, as the disease progresses: skin becomes hyperpigmented, skin of the whole upper body may become firm, leathery; the face looks mask-like; the lower extremities are not usually affected much. Flexion contracture of the fingers, wrists, elbows, subcutaneous calcifications or ulcers develop on the bony prominences, telangiectasias, skin becomes dry and rough and loses hair and the ability to sweat, restricted opening of the mouth, esophageal dysfunction: the esophagus is the most commonly involved visceral organ: dysphagia, regurgitation of stomach contents, and peptic esophagitis often occur, joint pain, swelling, stiffness of fingers and knees small intestine involvement: malabsorption, steatorrhea, weight loss, bloating, abdominal pain large intestine involvement: chronic constipation and fecal impaction, Respiratory/cardiovascular involvement: fibrosis of the lungs causes exertional dyspnea, dry cough, pleurisy; cardiac problems: causing 15% of PSS deaths: include arrhythmias, pericarditis, and conduction disturbances, renal involvement: causes half the deaths of PSS.

Naturopathic Approach

A naturopathic approach to treating someone with skin issues, regardless of the skin issue is usually very similar since we know that what is going on outside the skin is a direct reflection of what is going on inside the intestines. Therefore, although the exact protocol with certainly depend on the individual, a 4 ‘R’ gut restoration program as described in the gastrointestinal section is most commonly prescribed. Some skin conditions are more immune system related like Impetigo and scleroderma in which case an approach similar to that in the autoimmune/infection section may be prescribed. Listed below are some specific details in regards to some of the more common skin issues I see at the clinic, however, this is by no means a complete list of all of the skin conditions I have seen people with.