Limited cutaneous systemic sclerosis
- Limited cutaneous systemic scleroderma
Your QuestionMy mom is dying from this very painful and agonizing disease. She lost both of her legs 4 years ago due to the disease and it has now progressed to her hands, and it's looking as though it's now going to take her hands from her. The pain she bears is very difficult to endure. Is there anything that could help her?
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For pain management, studies have shown that oxycodone is effective and safe for pain due to severe skin ulcers, while topical lidocaine helps reduce pain of digital ulcers in individuals with systemic scleroderma.
There are also some lifestyle changes and home remedies that may be helpful for some individuals with CREST syndrome. To reduce Raynaud's symptoms, individuals may consider wearing gloves or mittens outdoors when the weather is cool, and indoors when reaching into the freezer, for example. To maintain the body's core temperature, individuals may dress in layers and wear a hat or scarf, thermal socks, and well-fitting boots or shoes that don't cut off the circulation. Individuals who smoke should talk to their doctor about the best ways to quit. Nicotine constricts the blood vessels, making Raynaud's phenomenon worse. Individuals who have difficulty swallowing may consider choosing soft, moist foods and chewing food well. To minimize acid reflux individuals may eat small, frequent meals; avoid spicy or fatty foods, chocolate, caffeine, and alcohol; and avoid exercising immediately before or after eating. Sitting upright for a couple of hours after a meal may also help. To help keep skin soft, individuals may avoid harsh soaps and detergents, while choosing gentle skin cleansers and bath gels with added moisturizers. Individuals may also consider bathing less frequently and taking brief baths and showers, using warm rather than hot water. Moisture levels in the home may be improved by using a humidifier to ease skin and breathing symptoms.
For additional information about how CREST syndrome may be treated, the following article from eMedicine may be helpful: http://emedicine.medscape.com/article/1064663-treatment#showall
The information provided here is for general educational purposes only. Individuals interested in learning about specific treatment options for themselves or family members should speak with their healthcare provider.
CREST syndrome is a multi-system condition, and therefore pain may be experienced with several of the signs and symptoms associated with the disease. For a general description of how each individual sign and/or symptom may be treated, please refer to the question "How might CREST syndrome be treated?" For pain associated with:
- Heartburn - this may be relieved by antacid medications that reduce the production of stomach acid.
- Raynaud's phenomenon - this may be relieved by medications that open small blood vessels and increase circulation.
- Calcinosis -localized surgery to remove the calcium deposits may be indicated.
- Skin ulcers - studies have shown that oxycodone is effective and safe for pain due to severe skin ulcers, while topical lidocaine helps reduce pain of digital ulcers.
- Jeanie C Yoon. CREST syndrome. eMedicine. September 22, 2009; http://emedicine.medscape.com/article/1064663-overview. Accessed 8/11/2011.
- Limited scleroderma (CREST syndrome). Mayo Clinic. June 2, 2011; http://www.mayoclinic.com/health/crest-syndrome/DS00580. Accessed 8/10/2011.
- Giuggioli D, Manfredi A, Colaci M, Ferri C. Oxycodone in the long-term treatment of chronic pain related to scleroderma skin ulcers. Pain Medicine. October 2010; 11(10):1500-1503. http://www.ncbi.nlm.nih.gov/pubmed/20456083. Accessed 8/11/2011.
- Ozgocmen S, Kaya A, Coskun BK. Topical lidocaine helps reduce pain of digital ulcers in systemic sclerosis (scleroderma). Clinical Rheumatology. May 2006; 25(3):378-379. http://www.ncbi.nlm.nih.gov/pubmed/16211339. Accessed 8/11/2011.