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The Massachusetts General Hospital Scleroderma Program specializes in the care of patients with scleroderma and related fibrosing conditions. Led by Flavia Castelino, MD, the Scleroderma Program delivers state-of-the-art multi-disciplinary care in the evaluation and treatment of patients with scleroderma and related conditions. We are committed to improving scleroderma patient care by developing better diagnostic and treatment options, and performing innovative research to advance our understanding of what causes scleroderma.
What is Scleroderma?
Scleroderma, or systemic sclerosis, is an autoimmune disease that affects the skin and internal organs, and can lead to thickening, or fibrosis. Scleroderma is a progressive disease that can produce complications ranging from mild to severe. Its two main forms are:
Our rheumatologists specialize in treating systemic sclerosis, the primary focus of our program. Symptoms of scleroderma vary from one person to the next, but some of the more common symptoms of scleroderma may include: skin thickening, pulmonary hypertension, scarring of the lungs leading to shortness of breath (called pulmonary fibrosis), problems of the gastrointestinal tract, including heartburn or difficulty swallowing, fingers that become numb and pale when exposed to the cold (called Raynaud's phenomenon), and kidney problems.
What to Expect
Our program is headquartered in the Yawkey Building on the Mass General main campus under the leadership of Dr. Flavia Castelino. Program physicians, Flavia Castelino, MD, Marcy Bolster, MD, and Sara Schoenfeld, MD will apply their clinical and research expertise in scleroderma to develop a personalized care plan for you. At your first appointment, you will undergo a complete medical history and physical examination. Your physician will look for key signs of scleroderma, such as skin thickening/hardening and blood-vessel irregularities. Your physician may also recommend blood tests or other diagnostic tests, such as pulmonary-function tests, imaging studies or an echocardiography.
Although there is no known cure for scleroderma, making an early diagnosis is important because it can prevent a mild case from becoming more severe, and it can give us a head start in treating other conditions that may develop, such as Raynaud's phenomenon, pulmonary hypertension, and pulmonary fibrosis. In addition, there are a number of new treatment options available, and your doctor may recommend a trial of one of these medications.
A Personalized Treatment Plan
Your disease severity and extent of organ-system involvement will determine your prognosis and treatment plan.
Treatments may include:
Depending on your symptoms, our rheumatologists will coordinate your treatment with other world-class specialists at Mass General, including cardiologists, dermatologists, gastroenterologists, nephrologists and pulmonologists. We work closely with all of these specialties. In particular, we collaborate with the Dermatology-Rheumatology Connective Tissue Disease Program where we also see patients with scleroderma and other skin disorders related to autoimmune diseases. We also work closely with our colleagues in the Pulmonary and Critical Care Unit who specialize in seeing patients with lung fibrosis and pulmonary hypertension (increased pressure in the lungs) that can also be part of scleroderma.
Promising Research is Underway
Although there is no known cure for scleroderma, research is underway at Mass General to find therapies that will improve the quality of care for our patients. Members of the Rheumatology Unit work with scientists in the Center for Immunology and Inflammatory Diseases (CIID) to better understand scleroderma and develop new treatments. In recent years, both the Rheumatology Unit and CIID have helped clarify the mechanisms underlying scleroderma. Flavia Castelino, MD has collaborated with Andrew Tager, MD of the CIID and Pulmonary and Critical Care Unit to study a new treatment (targeting the lipid mediator, lysophosphatidic acid [LPA]) for lung and skin manifestations of scleroderma. Moving forward, Dr. Castelino is leading efforts to host clinical trials that give patients access to promising novel therapies for scleroderma.
Browse open clinical trials
E-mail our Rheumatology Clinical Research Coordinator
Educating the Next Generation
As part of an elite teaching hospital, Mass General's Rheumatology Unit is committed to preparing the next generation of leading academic physicians, scientists, and clinician-educators. Our fellowship program, affiliated with Harvard Medical School, offers physicians experience in the clinical aspects of scleroderma. Internal medicine residents also gain exposure to scleroderma patients as part of their general training.
Accepting New Patients
Scleroderma, also called systemic sclerosis, is a chronic, degenerative disease that affects the joints, skin, and internal organs.
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