247 Nursing Assessment, Management and Treatment of Autoimmune Diseases
handled shoehorns, and raised toilet seats. ● Healthy lifestyle : Patients should be encouraged to get enough rest and sleep, avoid tobacco products, adhere to medication regimens, and eat a healthy diet. Scleroderma Scleroderma is an autoimmune con- nective tissue and rheumatic disease. It is characterized by inflammation in the skin leading to patches of tight, hard skin. Scleroderma develops as the result of overproduction and accumulation of collagen in body tissues (Mayo Clinic, 2019). Scleroderma is not contagious, in- fectious, cancerous, or malignant (Sclero- derma Foundation, 2021). Scleroderma can involve multiple body systems or just one area of the body (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2020). When scleroderma affects multiple body systems it is referred to as systemic scleroderma (National Institute of Arthri- tis and Musculoskeletal and Skin Diseas - es, 2020). The estimated incidence of systemic scleroderma in the US is 20 cases per mil- lion population. Its prevalence is estimat- ed at 276 cases per million population. Incidence and prevalence of systemic scleroderma in the US has been increas- ing in the last 50 years (Jimenez, 2020). Systemic scleroderma is not particularly common. An estimated 75,000 to 100,000 people in the US have the disease. Most patients are women between the ages of 30 and 50 (American College of Rheu- matology, 2019). Localized scleroderma is more common in children. Systemic scleroderma is more common in adults. However, scleroderma can develop in ev-
ery age group from infants to older adults (Scleroderma Foundation, 2021). Pathophysiology There are two major classifications of scleroderma: localized scleroderma and systemic sclerosis (SSc). Each classifica - tion has its own characteristics and prog- nosis (Scleroderma Foundation, 2021). Localized scleroderma The changes associated with localized scleroderma are found in only a few plac- es on the skin or muscles. It rarely spreads elsewhere in the body. Usually, localized scleroderma is rather mild (Scleroderma Foundation, 2021). There are two forms of localized sclero- derma: morphea and linear scleroderma (Scleroderma Foundation, 2021). ● Morphea . Morphea is characterized by waxy patches on the skin that vary in size, shape, and color. These patches may grow or shrink and may even disappear spontaneously. Skin underneath patches may thicken. Morphea typically develops between the ages of 20 and 50 but is often found in young children (Scleroderma Foundation, 2021). ● Linear scleroderma . This form of localized scleroderma often starts as a streak of hardened, waxy skin. It typically appears on the arm, leg, or forehead. It may form as a long crease on the head or neck that resembles a wound caused by a sword. Linear scleroderma usually involves the deeper layers of the skin as well as the surface layers of the skin. Linear scleroderma typically develops in childhood, and growth of affected limbs may be affected (Scleroderma Foundation, 2021).
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