CREST is a form of Systemic Sclerosis (scleroderma) which is characterized by Calcinosis (calcium deposits), usually in the fingers; Raynaud’s;loss of muscle control of the Esophagus, which can cause difficulty swallowing; Sclerodactyly, a tapering deformity of the bones of the fingers; and Telangiectasia, small red spots on the skin of the fingers, face, or inside of the mouth.
It takes only two of the five CREST symptoms for a diagnosis of CREST (either “pure” or “plus”) to be made. For example, a patient with Calcinosis and Raynaud’s would have CREST (which for precision may also be written as CRest, but it is CREST nonetheless.)
- Calcium deposits in skin
- Spams of blood vessels in respond to cold or stress
- Acid reflux and decrease in motility of esophagus
- Thickening and tightening of the skin on the finders and hands
- Dilatation of capillaries causing red marks on surface of skin
“Pure”CREST — by itself: “Pure” CREST is diagnosed when patients have two or more symptoms of CREST but they do not meet the criteria for either Limited or Diffuse Scleroderma. That is, they must not have tight skin above their wrists, and if there is tight skin on their fingers, they must not have either pitting digital ulcers or lung fibrosis.
“Plus” CREST — along with. When CREST symptoms appear along with another form of Scleroderma, it is referred to as, for example, “Limited Scleroderma plus CREST” or “Diffuse Scleroderma plus CREST.” A person may also have any other autoimmune disease ” plus CREST.”
Although some doctors still believe CREST is a useful subcategory, the existing research studies have been unable to predict consistently how (or whether) the disease will progress to Diffuse Systemic Scleroderma in any specific individual.
There is no cure for CREST syndrome, but with early recognition and supportive care, it is possible to decrease symptoms and help people with CREST syndrome to live as normally as possible. Treatment for CREST syndrome varies depending on the severity of symptoms, the presence of complications, a person’s age and medical history, and other factors.
The most successful care plans use a multipronged approach that incorporate a combination of medication, lifestyle changes and physical therapy and exercise.