Best treatment for scleroderma

Question

Should I be seeing a specialist in scleroderma or is the average rheumatologist capable of the best care? Also, I would like an opinion on treatment with penacillamine or some other antibiotic etc that is presently giving good results

Answer

The question on whether to be seen in a specialized scleroderma center is difficult to answer and likely depends on how severe your disease is. Dr. Fred Wigley who runs the Hopkins scleroderma center is universally thought of as a great doctor by both patients and colleagues. Thus I think a trip to see him is worthwhile if only for the educational experience. D-penicillamine is not an antibiotic but has effects on collagen in the skin (scleroderma is the result of too much collagen). It still has some fans, but a large, well done, well controlled trial showed that penicillamine did not affect the progression of scleroderma.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University