Tel: 03 6266 8308

The Monash Scleroderma Clinic has been running since 2003 at Clinic M, Monash Health in Clayton. We see about 380 patients with Scleroderma, providing clinical and wound care as well as annual screening for heart and lung complications of Scleroderma. Patients are seen in a bulk billing clinic with a referral from their GP and can access screening with lung function tests and echocardiogram (heart ultrasound) which can usually be performed on the same day as clinic appointments.

Our Scleroderma nurse attends each clinic to provide education, support, advice and assistance with wound care for patients. Patients requiring further cardiac or respiratory assessment can be referred to our onsite cardiologist, Dr  Roger Peverill and Respiratory physician Dr Chris Daley who form part of our team. Patients with foot ulcers can also be referred to and co-managed at the Monash High Risk Foot Clinic where they are seen by a multidisciplinary team which includes a podiatrist experienced in managing Scleroderma related foot problems. Patients attending our clinic can choose to enrol in the Australian Scleroderma Cohort Study.  This study is a longitudinal study involving patients from a number of centres around Australia which has facilitated improvement in our understanding of Scleroderma and its treatment. Participation is voluntary and involves answering some additional questions and providing some additional blood samples once a year.

At Monash, our particular interest has been in the cardiac and pulmonary complications of Scleroderma. Ongoing research interest include identification of predictors of progression of Scleroderma related lung fibrosis and defining the effect of Scleroderma on cardiac structure and function. The Monash Scleroderma clinic has also collaborated with an experienced team of scientists on site in the Monash Centre of Inflammatory diseases to undertake lab based research to advance our understanding of the disease mechanisms underlying Scleroderma. Monash also has a clinical trials unit which enrols patients in studies examining new treatments which may provide benefit beyond our existing treatment options.

Referrals to the Monash Scleroderma clinic should be addressed to:

Professor Eric Morand, Monash Rheumatology

Monash Health , Block E, Level 3, 246 Clayton Rd Clayton 3168

Tel: 03 9594 4899

Preferred means of referral. Fax: 03 9554 9200

Email: [email protected]

The Scleroderma clinic at Fiona Stanley Hospital in Western Australia is a weekly clinic taking place in the outpatient’s area within the hospital. Presently, the clinic manages over 300 patients with scleroderma and connective tissue diseases per year. The scleroderma team at Fiona Stanley Hospital comprises consultant rheumatologists, Dr Janet Roddy and Dr Lauren Host, clinical nurse Helen Marsden, rheumatology and basic physician trainees. We are privileged to work closely with consultant respiratory physician Dr Melanie Lavender and her team in the Advanced Lung Disease Unit, plastic surgeon Dr Sharon Chu and her team in the hand clinic. Working closely with Dr Lavender and Dr Chu allows us to provide a truly multi-disciplinary approach to our patients with complicated cardiorespiratory disease and severe digital ulcers respectively. Running in parallel to the scleroderma clinic we have a digital ulcer service comprising a nurse led “drop in” clinic for all of our patients providing an invaluable service for those who have digital ulcers that need immediate attention. Research areas of special interest in WA include the use of ultrasound to measure skin thickness, investigation and treatment of digital ulcers in scleroderma patients, and at present we are reviewing our experience of using rituximab in scleroderma patients with interstitial lung disease.

A scleroderma outpatient service was established at the Royal Adelaide Hospital in 2007 by Professor Susanna Proudman who was the inaugural Chair of the Australian Scleroderma Interest Group (ASIG). It is now located in the new Royal Adelaide Hospital, which lies within Adelaide’s Biomed City at the western end of the city. A dedicated scleroderma clinic is conducted weekly in the Outpatient Department Service where patients receive care for the full range of scleroderma disease features. All are assessed annually for pulmonary arterial hypertension (PAH). Some are referred to this clinic only for this annual assessment and continue to receive care from their private rheumatologist or specialist physician between visits. We are also fortunate to be able to offer a second rheumatology clinic held fortnightly with A/Professor Jenny Walker, a senior rheumatologist from the Flinders Medical Centre with expertise in scleroderma. Patients attending these clinics with ongoing scleroderma-related issues such as digital ulcers and PAH receive specialist nursing care including assessment, treatment advice and education from our rheumatology nurse practitioner Leah McWilliams. We work closely with cardiology and respiratory colleagues to access specialist assessment and care when needed. These clinics are highly valued by the doctors in training, comprising an advanced trainee in rheumatology and a basic physician trainee, who work in the Rheumatology Unit. These potential rheumatologists of the future appreciate the opportunity to learn about scleroderma from the patients themselves. All patients are offered the opportunity to participate in the Australian Scleroderma Cohort Study and contribute to ASIG’s research activities. Approximately 300 have been recruited from the RAH to date.

The Royal Adelaide Hospital Rheumatology Research Unit is managed by a Senior Medical Scientist. Together with other research staff, they work closely with Prof Proudman to afford our patients access to best practice evidence-based care and contemporary research. Dr Mahin Moghaddami is a basic scientist who manages the ASIG biobank housed in the University of South Australia’s Cancer Research Institute also located within Adelaide’s Biomed City. A select few patients seize the opportunity when approached to enrol in rheumatology research clinical trials expertly coordinated by Ms Cindy Hall which are often in collaboration with our extraordinary rheumatology colleagues across Australia.

Address referral to Professor Susanna Proudman, Head Rheumatology Unit and send to the Referral Management Hub:

Tel: 08 7074 1239

Fax: 08 7074 6247

Email: [email protected]

This study is being run by the Department of Rheumatology at the Institute of Rheumatology and Orthopaedics (IRO), which is located in the Queen Elizabeth 2 building of Royal Prince Alfred Hospital. The IRO is comprised of rheumatologists, nurses, allied health professionals and supporting consultants who care for patients with bone, joint and connective tissue diseases.

Referrals to Royal Prince Alfred Hospital should be addressed to:

Prof Peter Youssef

Royal Prince Alfred Hospital, Rheumatology Department, Level 4, Queen Elizabeth II Building, 59 Missenden Road, Camperdown NSW 2050

Tel: 02 9515 9337

Fax: 02 9515 9466

Located in Fitzroy in central Melbourne, St. Vincent’s Hospital Melbourne is one of the founding sites of the Australian Scleroderma Cohort Study, with patients attending St. Vincent’s Rheumatology Clinics being a part of the study since 2007. Over 500 scleroderma patients in the Australian Scleroderma Cohort Study (ASCS) have been recruited from St. Vincent’s, where they attend their yearly review and receive regular scleroderma care. The ASIG database is managed out of the St. Vincent’s Hospital Melbourne Department of Rheumatology. Our unit has long had a special interest in all aspect of management and assessment of  cardiopulmonary complications especially PAH and ILD.  We have a strong commitment to clinical trials in all aspects of scleroderma. In particular, over the last 10 years we have been involved in novel treatments for digital ulcers, Diffuse skin disease, Pulmonary hypertension and interstitial lung disease. The unit has recently acquired a 200 fold nailfold capillaroscopy unit and has an interest in using this in the diagnosis of very early Scleroderma.  A recent research project has looked at patterns of nailfold abnormalities as predictor of digital ulcer and other organ feature. This is an area of ongoing interest.

Referrals to St. Vincent's Hospital Melbourne should be addressed to:

Dr Wendy Stevens/ Dr Mandana Nikpour/ Dr Nava Ferdowsi/ Dr Laura Ross

Department of Rheumatology, St Vincent’s Hospital Melbourne, 41 Victoria Parade, Fitzroy

Tel: 03 9231 3983

Fax: 03 9231 3841