I have a scleroderma patient I am really struggling with. I got into wound care in 1990 and it’s wonderful to see all the studies that have been published about new treatments for patients with scleroderma. I was just kidding because there haven’t really been any.
Scleroderma is one of the many exclusion criteria in all cellular product trials that I know of, and as a result, ends up being an exclusion for the use of cellular products in nearly every Local Coverage Determination (LCD) for cellular products. Like sickle cell ulcers and many other “orphan diseases” that are really hard to heal and cost a fortune to care for, we don’t know much more than we did about what works than we knew in 1990.