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Etiopatogenia y tratamiento de la esclerodermia. Conceptos actuales
Resumen
La esclerodermia es una enfermedad multisistémica caracterizada por cambios inflamatorios, vasculares y escleróticos de la piel y de órganos internos. Es una enfermedad tripartita asociada con defectos endoteliales, de autoinmunidad y de fibroblastos, desencadenados por factores genéticos, ambientales e infecciosos. Puede clasificarse en sistémica y localizada. El fenómeno de Raynaud ocurre en 90 % de los pacientes con esclerodermia, y explica la afección de la microcirculación y la disminución en el número de vasos capilares. La capilaroscopia establece la correlación de los órganos internos con la severidad de la enfermedad y el grado de involucramiento. El MRSS-51 es el método clínico que valora la afección cutánea y posee el mayor valor predictivo para determinar la supervivencia, pero no deberá ser considerado un marcador de actividad de la enfermedad ni utilizarse para validar la eficacia de un tratamiento. Hasta el momento existen diversas alternativas para tratar la esclerodermia; sin embargo, pocas son efectivas para la afección cutánea ocasionada por la enfermedad.
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