The Physician's Page Vol. The Next Step David E. Trentham, MD, is a rheu-matologist at Beth Israel Deaconess Medical Center in Boston, MA, an associate professor at Harvard Medical School, and has published numerous papers on varying aspects of rheumatic disease. No universally effective treatment for scleroderma exists and many drugs used for this disease can, on occasion, produce toxic side effects. In an uncontrolled trial involving 11 patients with early but severe diffuse scleroderma, oral minocycline was well tolerated and appeared to improve the skin manifestations in 4 of 6 patients that completed a year of treatment.
Expanded studies are in order.
For those on interventional treatment, a 1-month washout occurred. Patients were started on oral minocycline and evaluated at 3-month intervals for the subsequent year. Three patients washed off penicillamine and 1 methotrexate. Yeast infection developed in two patients and transient nausea and dizziness in another. Results Patients were begun on 50 mg.