In the United States alone, there is an estimated 50 million people living with autoimmune disease. Of those 50 million, researchers believe 75 percent of them are women. With so many people affected,there is still a lack of understanding about what an autoimmune disease actually is.
From Visually.
Scleroderma
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| Attribution: Leith C Jones at English Wikipedia |
Scleroderma is an uncommon condition that results in hard, thickened areas of skin and sometimes problems with internal organs and blood vessels.
Scleroderma is caused by the immune system attacking the connective tissue under the skin and around internal organs and blood vessels. This causes scarring and thickening of the tissue in these areas.
There are several different types of scleroderma that can vary in severity. Some types are relatively mild and may eventually improve on their own, while others can lead to severe and life-threatening problems.
There’s no cure for scleroderma, but most people with the condition can lead a full, productive life. The symptoms of scleroderma can usually be controlled by a range of different treatments.
There are two main types of scleroderma:
localised scleroderma – just affects the skin
systemic sclerosis – may affect blood circulation and internal organs as well as the skin
Localised scleroderma is the mildest form of the condition. It often affects children, but can occur at any age.
This type just affects the skin, causing one or more hard patches to develop. Internal organs aren’t affected.
Exactly how the skin is affected depends on the type of localised scleroderma. There are two types, called morphoea and linear.
Morphoea:
discoloured oval patches on the skin
can appear anywhere on the body
usually itchy
patches may be hairless and shiny
may improve after a few years and treatment may not be needed
Linear:
thickened skin occurs in lines along the face, scalp, legs or arms
occasionally affects underlying bone and muscle
may improve after a few years, although can cause permanent growth problems, such as shortened limbs
In systemic sclerosis, internal organs can be affected as well as the skin. This type mostly affects women and usually develops between 30 and 50 years of age. Children are rarely affected.
There are two types of systemic sclerosis, called limited cutaneous systemic sclerosis and diffuse systemic sclerosis.
Limited cutaneous systemic sclerosis:
a milder form that only affects skin on the hands, lower arms, feet, lower legs and face, although it can eventually affect the lungs and digestive system too
often starts as Raynaud’s phenomenon (a circulation problem where fingers and toes turn white in the cold)
other typical symptoms include thickening of the skin over the hands, feet and face, red spots on the skin, hard lumps under the skin, heartburn and problems swallowing (dysphagia)
tends to get gradually worse over time, although it’s generally less severe than diffuse systemic sclerosis and can often be controlled with treatment
Diffuse systemic sclerosis:
is more likely to affect internal organs
skin changes can affect the whole body
other symptoms can include weight loss, fatigue and joint pain and stiffness
symptoms come on suddenly and get worse quickly over the first few years, but then the condition normally settles and the skin may gradually improve
In some cases of systemic sclerosis, organs such as the heart, lungs or kidneys are affected. This can cause a range of potentially serious problems, such as shortness of breath, high blood pressure and pulmonary hypertension (high blood pressure in the lungs).
Normally, the body’s immune system fights off any germs that infect the body. It responds like this to anything in the body it doesn’t recognise, and settles down when the infection has been cleared.
It’s thought scleroderma occurs because part of the immune system has become overactive and out of control. This leads to cells in the connective tissue producing too much collagen, causing scarring and thickening (fibrosis) of the tissue.
It’s not clear why this happens. Certain genes are thought to be involved, and having a close family member with the condition may increase your risk.
The aim of treatment is to relieve symptoms, prevent the condition getting worse, detect and treat any complications (such as pulmonary hypertension) and help you maintain the use of affected parts of the body.
Common treatments include:
medication to improve circulation
medicines that reduce the activity of the immune system and slow the progression of the condition
steroid medication to relieve joint and muscle problems
moisturising affected areas of skin to help keep it supple and relieve itchiness
various medicines to control other symptoms (such as pain, heartburn and high blood pressure)
You will also need regular blood pressure checks and other tests to check for any problems with your organs.
If your symptoms are severe, surgery may be needed. For example, hard lumps under the skin may need to be removed, and tightened muscles may need to be loosened.
Newer treatments such as laser therapy and photodynamic therapy are currently being trialled (see Scleroderma clinical trials), and may improve the outcome of the condition for many people.
There are many therapies and lifestyle changes that can help reduce the impact of scleroderma on your life.
Regular physiotherapy and stretching exercises may help keep your muscles supple and loosen tight skin.
An occupational therapist can help you adapt to any movement difficulties by suggesting changes to your home and advising you on equipment to make daily life easier.
If you’re affected by Raynaud’s phenomenon, you’ll need to keep your hands and feet warm in the cold by wearing thick gloves and socks. Read more about treating Raynaud’s phenomenon.
It’s important to eat healthily, exercise regularly and stop smoking (if you smoke) to keep blood pressure under control and improve your circulation. Read more about controlling high blood pressure.
Many people find it helps to read up on the condition and talk to other people who are affected. Scleroderma & Raynaud’s UK (SRUK) is dedicated to improving the lives of people affected by Scleroderma and Raynaud’s.
Crohn’s disease
Crohn’s disease is a long-term condition that causes inflammation of the lining of the digestive system.
Inflammation can affect any part of the digestive system, from the mouth to the back passage, but most commonly occurs in the last section of the small intestine (ileum) or the large intestine (colon).
Common symptoms can include:
fatigue (extreme tiredness)
unintended weight loss
blood and mucus in your faeces (stools)
People with Crohn’s disease sometimes go for long periods without symptoms or with very mild symptoms. This is known as remission. Remission can be followed by periods where symptoms flare up and become particularly troublesome.
Read more about the symptoms of Crohn’s disease and diagnosing Crohn’s disease.
The exact cause of Crohn’s disease is unknown. However, research suggests a combination of factors may be responsible. These include:
genetics – genes you inherit from your parents may increase your risk of developing Crohn’s disease
the immune system – the inflammation may be caused by a problem with the immune system (the body’s defence against infection and illness) that causes it to attack healthy bacteria in the gut
previous infection – a previous infection may trigger an abnormal response from the immune system
smoking – smokers with Crohn’s disease usually have more severe symptoms than non-smokers
environmental factors – Crohn’s disease is most common in westernised countries such as the UK, and least common in poorer parts of the world such as Africa, which suggests the environment has a part to play (known as the hygiene hypothesis)
Read more about the possible causes of Crohn’s disease.
There’s currently no cure for Crohn’s disease, so the aim of treatment is to stop the inflammatory process, relieve symptoms (induce and maintain remission) and avoid surgery wherever possible.
The first treatment offered to reduce symptoms is usually steroid medication (corticosteroids). If this doesn’t help, medication to suppress the immune system (immunosuppressants) and medication to reduce inflammation may be used.
In some cases, surgery may be needed to remove the inflamed section of intestine.
Once your symptoms are under control (in remission), further medication may be needed to help maintain this.
Crohn’s disease is a relatively uncommon condition. There are currently at least 115,000 people living with the condition in the UK.
Crohn’s disease can affect people of all ages, including children. However, most cases first develop between the ages of 16 and 30.
A large number of cases also develop between the ages of 60 and 80.
It affects slightly more women than men, but in children more boys are affected than girls.
The condition is more common in white people than in black or Asian people. It’s most prevalent among Jewish people of European descent.
Read more about treating Crohn’s disease.
Over time, inflammation can damage sections of the digestive system, resulting in complications such as narrowing of the intestine (stricture), or a channel developing between the end of the bowel and the skin near the anus or vagina (fistula). These problems usually require surgical treatment.
Read more about the possible complications of Crohn’s disease.
Barbara Grubbs – what is an autoimmune disease?
Barbara Grubbs shares her brilliant explanation of what actually is an autoimmune condition.
Some of the conditions (there are over 100) that are defined as autoimmune include
alopecia areata
autoimmune hemolytic anemia
autoimmune hepatitis
dermatomyositis
diabetes (type 1)
glomerulonephritis
Graves’ disease
Guillain-Barré syndrome
idiopathic thrombocytopenic purpura
myasthenia gravis
some forms of myocarditis
multiple sclerosis
pemphigus/pemphigoid
pernicious anemia
polyarteritis nodosa
polymyositis
primary biliary cirrhosis
psoriasis
rheumatoid arthritis
scleroderma/systemic sclerosis
Sjögren’s syndrome
systemic lupus erythematosus
vitiligo
granulomatosis with polyangiitis (Wegener’s)
Some also include fibromyalgia in the list!
