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Scleroderma Program

The Massachusetts General Hospital Scleroderma Program provides expert multidisciplinary care for scleroderma (systemic sclerosis) and conducts research to enhance our understanding of the disease and develop new treatments.

A Team Approach to Treating Scleroderma

Scleroderma, or systemic sclerosis, is an autoimmune disease in which the immune system attacks the body's organs and tissues. This progressive condition can lead to the thickening or hardening of the skin, joint pains, blood-vessel dysfunction and involvement of multiple internal organs.

Multidisciplinary expertise—a hallmark of care at Mass General—is essential in managing multi-system diseases like scleroderma. Our rheumatologists take a team approach to care, coordinating treatment with other world-class specialists at Mass General, such as:

  • Cardiologists
  • Dermatologists
  • Gastroenterologists
  • Nephrologists
  • Pulmonologists

Members of the Mass General Rheumatology Unit also work with scientists in the Center for Immunology and Inflammatory Diseases to better understand scleroderma and develop new treatments. We expect these collaborative efforts will help improve the quality of care for our patients.

What to Expect

Our program is headquartered in the Yawkey Building on the main Mass General campus. Many of our services are also available at Mass General West in Waltham and our community health centers in Charlestown and Chelsea.

All of our rheumatologists care for scleroderma patients. 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. He or she may also recommend blood tests or other diagnostic tests, such as pulmonary-function tests or echocardiography.

Currently, there is no known cure for scleroderma. However, making an early diagnosis is important because:

A Personalized Treatment Plan

Your specific diagnosis—in particular, disease severity and extent of organ-system involvement—will determine your prognosis and treatment plan. Treatment may include:

  • Nonsteroidal anti-inflammatory medications to relieve joint pains
  • Immunosuppressive medications to control the body's immune response
  • Medications for treating specific scleroderma symptoms
  • Physical therapy and exercise to promote muscle strength and joint mobility

Most of our patients receive lifelong care at Mass General. We typically see patients with mild symptoms every three to six months and patients with more severe symptoms every one to three months. At each visit, you can expect to meet with your rheumatologist, who will then coordinate care with other specialists.

If you do not live in the area, we can co-manage care with your local physician and see you yearly to monitor your health.

Two Forms of Scleroderma

Scleroderma is a progressive autoimmune disease that can produce complications ranging from mild to severe. Its two main forms are:

  • Localized scleroderma, which affects a local area of the skin (and is most often treated by dermatologists)
  • Systemic sclerosis, which can affect the skin, joints, blood vessels and internal organs

Our rheumatologists specialize in treating systemic sclerosis, the primary focus of our program. Depending on how the patient is affected, our rheumatologists can work together with other world-class specialists at Mass General—including cardiologists, dermatologists, gastroenterologists, nephrologists and pulmonologists—to manage care.

Promising Research Is Underway

Although there is no known cure for scleroderma, research is underway at Mass General to find therapies that will improve management of this condition.

In recent years, the Mass General Rheumatology Unit and the Center for Immunology and Inflammatory Diseases have helped clarify the mechanisms underlying scleroderma and common complications such as pulmonary fibrosis. Division chief Andrew Luster, MD, PhD, and Flavia Castelino, MD , have collaborated with Andrew Tager, MD, of the Mass General Pulmonary and Critical Care Unit to study a new treatment for the lung and skin manifestations of scleroderma. This treatment will be ready for clinical trials in humans in the near future.

Moving forward, program director Dr. Castelino will lead our efforts to host clinical trials that give patients access to promising novel therapies for scleroderma.

Educating the Next Generation

As part of an elite teaching hospital, the 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.

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