Editing Systemic scleroderma (section)

===Topical/symptomatic===
Topical treatment for the skin changes of scleroderma do not alter the disease course, but may improve pain and ulceration. A range of [[NSAID|nonsteroidal anti-inflammatory drugs]], such as [[naproxen]], can be used to ease painful symptoms.{{Citation needed|date=May 2008}} The benefit from [[glucocorticoid|steroids]] such as prednisone is limited.{{Citation needed|date=May 2008}} Episodes of Raynaud's phenomenon sometimes respond to [[nifedipine]] or other calcium channel blockers; severe digital ulceration may respond to [[prostacyclin]] analogue [[iloprost]], and the dual endothelin-receptor antagonist [[bosentan]] may be beneficial for Raynaud's phenomenon.<ref name=Zandberg>{{cite journal |vauthors=Zandman-Goddard G, Tweezer-Zaks N, Shoenfeld Y |title=New therapeutic strategies for systemic sclerosis--a critical analysis of the literature |journal=Clin. Dev. Immunol. |volume=12 |issue=3 |pages=165–73 |year=2005 |pmid=16295521 |doi=10.1080/17402520500233437 |pmc=2275417}}</ref> Skin tightness may be treated systemically with [[methotrexate]] and [[ciclosporin]].<ref name=Zandberg/> and the skin  thickness can be treated with penicillamine.