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Treatment of Scleroderma with Para-Aminobenzoic Acid: Effect on Disease Morbidity.

Khalid Sawalha

This is an expedited review of literature that dives into the less well-known aspects of Scleroderma, also known as systemic sclerosis. Scleroderma is an autoimmune chronic systemic inflammatory disorder of the connective tissue that is characterized by collagen deposition in the skin and other internal organs. The incidence of scleroderma in the United States is approximately 20 cases per million per year while the estimated prevalence is 240 cases per million. The incidence is higher in African Americans and more prevalent in women than in men (4.6:1). Although the etiology of scleroderma is not well identified, exposure to environmental factors, including viruses, certain toxins or drugs, may provoke the disease in genetically susceptible hosts. Collagen deposition and fibrosis of the skin and body organs, such as lung, esophagus, and heart is the reason for the variable clinical presentations of scleroderma. Hardening of the skin and dysphagia, are the most common presentation of scleroderma. Scleroderma is a devastating disease that decreases the quality of life significantly. Pulmonary and cardiac involvement is the leading cause of death. As the pathogenesis of scleroderma is poorly understood, and due to the variable manifestation of the disease, there is no curative treatment available to date. The management usually targets the symptomatology and it is customized based on the involved internal organ. Immunotherapy has been widely used in the treatment of scleroderma; however, its efficacy has not been well established. Other alternative symptomatic therapy including Para-aminobenzoic acid decreases the progression of skin fibrosis and improves survival.