Scleroderma

A rare autoimmune condition causing hardening and tightening of the skin — and in systemic forms, affecting blood vessels, lungs, kidneys, and the gut. It exists on a spectrum from limited skin involvement to serious organ disease, and specialist-led monitoring is the backbone of care.

Evidence synthesis: Scleroderma involves autoimmunity, vascular damage, and fibrosis — collagen overproduction driven by immune dysregulation — and management guidelines centre on organ-based monitoring and targeted therapies (e.g. ACE inhibitors for renal crisis, which transformed survival; immunosuppressants for lung fibrosis). Raynaud's precedes diagnosis in most patients and is managed per standard evidence. Vitamin D deficiency is documented at high rates in systemic sclerosis cohorts, and repletion is reasonable bone-health practice, but no supplement has trial evidence for modifying the disease. Antioxidant and immune-boosting supplements lack support, and immune stimulation is theoretically counterproductive in autoimmune disease. Skin-directed care (moisturisation, physiotherapy for contractures) and prompt treatment of reflux and digital ulcers are evidence-supported quality-of-life measures.