Scleroderma Causes, Types, Diagnosis & Ayurvedic Treatment

Abstract

Scleroderma known as systemic sclerosis. It is a connective tissue disorder. It is characterized by thickening and hardening of skin. The combination forms “Sclero” which means Hard and the word “Derma” means skin in Greek. This disease primarily affects skin, blood vessels and some internal organs. Scleroderma has two major classifications that are localized and systemic scleroderma. The hallmark of this disease is excessive collagen production and deposition which leads to thickening and hardening of skin. There is no definitive cure for scleroderma treatment primarily aimed at managing symptoms and preventing further organ damage. Here, in this article we will discuss its ayurvedic overview and its management.

Introduction

Scleroderma is a group of autoimmune diseases that may result in change in skin, blood vessels, muscles or internal organs. This condition could be localised to one part or involve other organs like lungs, heart, kidney and digestive system. This occurs when the body’s immune system attacks healthy tissue, leading to excessive collagen production, which causes fibrosis (Scarring) of the skin and internal organs.

There are two main types of scleroderma

1. Localized scleroderma

Localised means concentrated on one area. It causes thick patches or streaks on skin that feels waxy. Localised scleroderma resolves on its own. It usually does not spread to other parts of the body. It is also known as morphea 

Localised scleroderma is further divided in 3 subtypes

1. Circumscribe Morphea :-  This appears as a single oval shape morphea. Morphea usually appears as patches on the skin and these patches can be of different sizes.  It has a red border which will be thick and yellow from the center.  If these lesions are not treated then they may enlarge and flattened. After treatment they become asymptomatic but if left untreated then they may extend to deep subcutaneous tissue.
2. Generalised Morphea :- This can show up as several patches on different parts of the body such as torso, neck, head and arms. These patches tend to be thick and they may merge together. Pan sclerotic morphea is the severe form of generalised morphea.
3. Linear Morphea :- This is Most common in children under 10 years old. It can show up as thick, tight bands on the arms, legs, front of the torso, face and buttocks. These bands may appear as a single patch or multiple patches.  It can affect the muscles and bone. When linear scleroderma affects the kids on their legs and arms, it can lead to underdevelopment of limbs and can cause disability.

2. Systemic scleroderma-(Systemic sclerosis)

It can affect other organs including skin. It affects the respiratory system and digestive system. It can lead to multiple complications.

Systemic scleroderma is further divided into 3 subtypes

Limited scleroderma :-  It is the most common form of scleroderma.The skin on fingers, forearms, hands and face can become hard and tight. It does not cause any internal damage to the organ. Some people may have problems related to their GI tract. That includes heartburn, musculoskeletal pain and severe Raynaud

The type of limited scleroderma, also known as CREST syndrome, which is acronym of

• alcinosis (Calcium deposition under the skin and sometimes in tissue)
• Raynaud’s phenomenon (A aggravated response to a temperature, which makes fingers and toes cold and numb)
• Esophageal dysmotility (This condition cause heartburn)
• Sclerodactyly  (This condition leads to thickening of finger skin)
• Telangiectasias (This cause enlarged blood vessels that appears as red spot  on face and fingers)

2. Diffuse scleroderma

• This condition can cause the body to produce too much collagen, leading to thickening of the skin in areas like the hands, fingers, arma, legs and face. It can also cause serious damage to organs such as the digestive system, lungs, kidney and heart.
• When the skin tightens, it can also become itchy and dry. Musculoskeletal pain is common. It can become life threatening when it affects the heart and lungs. 

3. Sine Scleroderma

• It causes symptoms similar to other conditions like Raynaud's disease, but there won't be any skin thickening

Causes

No exact cause for Scleroderma. The process of this disease development is unknown. As it is an Autoimmune disease it could be caused due to family history of this disease and some environmental factors

Symptoms

The symptoms of scleroderma may differ from person to person. Some common symptoms includes

1. Red spot on the skin
2. Swelling on hands and feet
3. Joints contracture
4. Sores on fingertips and toes
5. Stiffness
6. Tightness in the skin on the face
7. Joint pain
8. Difficulty in breathing
9. Persistent cough
10. Heartburn
11. Weight Loss
12. Hairfall
13. Constipation
14. Fatigue

Diagnosis

Diagnosis of Scleroderma depends on the symptoms. On complete physical examination, the exam may show:

1. Tightening and hardening  of skin (Fingers, Face or other body part)
2. Skin at the base of the fingernails may be looked by magnifying glass for the abnormalities of small blood vessels.
3. Lungs, Heart and abdomen for some abnormalities

Blood Test and Urine Tests

1. Antinuclear Antibody (ANA) pannel
2. Scleroderma antibody testing
3. ESR
4. Rheumatoid factor
5. Complete blood cell count
6. Heart muscle test
7. Urine analysis

Other test may include

1. Chest x-ray
2. CT scan for the lungs
3. Electrocardiogram (ECG)
4. Echocardiogram (ECG)
5. Skin biopsy

Treatment

There is no cure for scleroderma, relief from symptoms may be achieved. These includes the treatment of :

1. Raynaud’s phenomenon : Vasodilators such as Calcium channel blocker, Alpha blocker, Serotonin receptor antagonist.
2. Digital ulcers : Phosphodiesterase 5 inhibitor and Iloprost
3. New digital ulcers : Bosentan
4. Interstitial lung disease : Cyclophosphamide and Azathioprine
5. Pulmonary arterial hypertension : Endothelin receptor antagonist , phosphodiesterase 5 inhibitor
6. Gastroesophageal reflux disease : Antacids and prokinetics
7. Kidney disease : Angiotensin converting enzyme inhibitor

Ayurvedic Overview

According to Ayurveda, Twacha (Skin) is the first line of defence for the body. Diseases that manifest 7 layers of skin are considered as Twakroga (Skin disorders). Scleroderma in ayurveda is nearly considered to be Uttan Vatarakta. In this disease when Vata and Rakta (Blood tissues) aggravate and move upwards. It affects superficial tissues such as skin and muscle.

Symptoms

Scleroderma is correlated with Uttan Vatarakta and it includes symptoms, such as :

1. Twak sankocha (Stretching of skin) - Vata
2. Hasta- Anguli evum Sandhi sankocha (Stiffness in hands, fingers and joints)- Vata and Kapha
3. Twak Parushtam (Roughness on skin) - Vata
4. Twak Karshnaya (Black discolouration of skin) - Vata
5. Anguli agra bhag sphota (Blisters on the digital phalanges) - Rakta and Vata
6. Rakta- Krishna varna Mandalotpatti (Reddish- black skin patches) - rakta, pitta, vata
7. Sankocha janya rujha (pain on movement of joints) - Vata
8. Kandu (Itching) - Kapha
9. Sira ayam (Stretching of vessels) - Vatarakta

Treatment

Ayurvedic treatment of scleroderma involves the treatment that eliminates the root cause of this condition.  It involves the Shaman (Pacifing therapy) and Shodhan (Purification therapy) Chikitsa.

Shaman Chikitsa (Pacifing therapy)

1. Vasadi kwath
2. Guduchi kwath
3. Manjistha kwath
4. Gandhak Rasayan
5. Kishor Guggulu
6. Mahatikta Ghrita 

Shodhan chikitsa (Purification therapy)

1. Abhayang (Massage) with Bala tailam
2. Swedana (Sweating therapy) with Dashmool kashayam
3. Sarwang Lepa (Herbal paste application on hole body)
4. Matra Basti (Daily oil enema)

Herbal Remedies for Scleroderma by Planet Ayurveda

Planet Ayurveda is an Ayurvedic herbal medicine manufacturing company. It is GMP certified. They offer a wide range of natural remedies made 100% pure, chemical and preservative free. All their formulations are prepared under the supervision of MD (Ayurveda) scholars. They deal with all complicated to serious and chronic diseases. They provide the combination of best herbal drugs which are effective in Scleroderma. Planet Ayurveda has a Sclero care pack which is a combination of some amazing formulations. This pack is made from 100% natural herbs and it has no side effects.

Sclero care pack

Products Description

1. Ashwagandha capsules

This capsule is prepared by the pure extract of Ashwagandha (Withania Somnifera). It is a single herb formulation. It is a popular adaptogenic herb in Ayurveda. It helps to regulate the immune system so It is often used in autoimmune diseases like scleroderma. It has an anti-inflammatory effect which can help with swelling in scleroderma. It acts as an antioxidant which can help in protecting cells from oxidative stress.

Dosage: 1 capsule twice daily with lukewarm water after a meal.

2. Boswellia curcumin capsules

This capsule has poly herbs. This formulation is standardised pure extract of two herbs . These two herbs are Haridra (Curcuma Longa) and Shallaki (Boswellia Serrata). Shallaki (Boswellia Serrata) is known for its Anti Inflammatory and immunomodulating properties. It has antioxidative effects also so it helps in protecting body cells. Haridra (Curcuma Longa) has also Antiinflammatory and antioxidant properties thus helpful in Scleroderma.

Dosage:- 2 capsule twice daily with warm water

3. Gotu Kola capsules

This capsule has a single herb. It has pure extract of Mandukaparni (Centella Asiatica). It is also known as  Gotu kola. It is used for its wound healing effect. It has the ability to increase the production of collagen and fibroblasts which is essential for tissue production. Gotu Kola (Centella Asiatica) improves blood circulation which helps in Raynaud’s phenomenon. So, it is very effective in the treatment of scleroderma.

Dosage:- 2 capsule twice daily with lukewarm water

4. Sanjivani Vati

This tablet is a blend of some herbs. These are standardised pure extract of Vidanda (Embelia Ribes), Ginger (Zingiber Officinale), Haritaki (terminalia Chebula), Amalaki (Emblica Officinalis), Pippali (Piper Longum), Vacha (Acorus Calamus), Guduchi (Tinospora Cordifolia), Shuddh Vatsnabh (Aconitum ferox), Shuddh bhallataka (Semecarpus Anacardium). It has rejuvenating, anti-inflammatory and immunomodulatory effects. It is considered as an adaptogen and is often used to support overall vitality, promote healing and balance the body's system. So, This is suitable for Scleroderma.

Dosage:- 1-2 tablets thrice daily with warm water.

5. Gandhak Rasayan

These tablets are pure extract of single ingredient Gandhak (Sulphur). It helps in improving blood circulation which helps during Raynaud’s phenomenon. It also purifies blood. It has anti-inflammatory and detoxifying effects so it is helpful in scleroderma.

Dosage:- 2 tablets twice daily with lukewarm water.

6. Sinhnaad guggul

These tablets are extract of Shuddha guggulu (Commiphora Wightii),  Shuddha gandhak (Purified Sulphur), Haritaki (Termanalia Chebula), Bibhitaki (Terminalia Bellirica), Amalaki (Emblica Officinalis). It has immuno modulating, detoxifying and anti-inflammatory properties. So it is used in scleroderma.

Dosage:- 2 tablets twice daily with lukewarm water

Conclusion

The safest management to scleroderma with Ayurveda is by combining it with traditional medical treatment. All ayurvedic medications used in scleroderma have Antiinflammatory, detoxifying and immunomodulatory effects. Ayurveda focuses on balancing the body and addressing the root cause of the disease. Ayurveda takes a personalised approach and addresses the unique needs of the individual by balancing the body’s energies and improving overall wellness. Panchkarma therapies, Classic medications and Planet Ayurveda’s sclero care pack provides the best treatment for scleroderma.