DEAR DR. DONOHUE: My sister passed away from scleroderma. I don’t know anything about this disease. Will you explain it? – L.N.

ANSWER: The literal translation of “scleroderma” (SKLARE-uh-DUR-muh) is “hard skin,” and hard skin is this illness’s distinctive feature. Collagen – the stuff that forms scar tissue – infiltrates the skin, thickens it and renders it inelastic. Facial skin becomes so taut that it’s impossible to smile. Hand skin is so tight that the fingers won’t bend.

Collagen also invades internal organs. Collagen in the esophagus makes swallowing difficult. In the lungs it produces coughing and breathlessness. In the heart it enfeebles the heart’s beat and causes abnormal rhythms. When it attacks kidneys, blood pressure rises. Joints can become fixed and bent.

Scleroderma probably is an autoimmune disease – one where the immune system triggers this abnormal response. Unidentified environmental factors must play a role, and genes have an influence.

Treatment centers on taking care of the scleroderma damage that’s most troublesome to the person. In previous years, kidney involvement, with high blood pressure, was a common cause of death. Now with medicines called ACE inhibitors, deaths from kidney failure and hypertension have been dramatically reduced.

All patients and relatives of patients can turn to the Scleroderma Foundation for the latest information on treatment and for the comfort of knowing that there is someone championing scleroderma patients. The foundation’s toll-free number is 800-722-HOPE, and its Web site is www.scleroderma.org.

DEAR DR. DONOHUE: What is pemphigoid? I was diagnosed with it three years ago. I have taken only ointments and prednisone. I am told this is not cancer. It makes me itch and burn. – I.H.

ANSWER: Medical words that end in “oid” mean “similar to.” Pemphigoid is similar to pemphigus.

The “pemph” part of both words indicates blisters. They are blister-forming skin diseases, with pemphigus being worse than pemphigoid. But pemphigoid is bad enough.

With pemphigoid, large blisters break out in the groin, under the arm, on the trunk, on the thighs, on the forearms or on all of these places. The first inklings of trouble are red patches that look like hives and itch like them. The patches evolve into blisters.

This is another example of an illness that is believed to arise from an immune system that, in this case, turns on the skin.

Pemphigoid most often happens at older ages. Its onset is usually between 65 and 75.

Antihistamines – Atarax is an example – can control the itching. Cortisone ointments, creams or lotions minimize blister formation. When the situation is extensive, oral cortisone drugs – prednisone being the most often chosen – are called into play.

The blisters break and heal on their own. As disconcerting and uncomfortable as this illness is, there is a bright spot: It often goes way after five to six years. Those five to six years are anything but good years.

DEAR DR. DONOHUE: I have Peyronie’s disease. It came on almost overnight. Would you please discuss it? A urologist used words like “bubble gum” to describe it and left me confused. – G.S.

ANSWER: Peyronie’s (pay-row-KNEES) disease happens to older men. Scar tissue forms in the penis and bends it. The bend can be so pronounced that sexual relations become painful or just not possible. Small injuries – so small that they are unnoticed throughout the years – might be the cause of it.

A number of oral medicines, such as Potaba, have been used, but none has been an outstanding success. Injecting the scar tissue with the heart medicine verapamil is another treatment. Surgical removal of the scars is possible.

Sometimes the condition gets better on its own.

DEAR DR. DONOHUE: Please tell me what ministrokes are, and how to deal with them. My husband, according to our doctor, has had a couple. – J.T.

ANSWER: “Ministrokes” refers to two different circulatory problems of the brain. One is transient ischemic attacks, and the other is blockage of small brain arteries.

Transient ischemic attacks – TIAs – are temporary losses of brain function due to a short interruption of blood flow to a part of the brain. A person might experience weakness of an arm or leg, have difficulty speaking or become numb in a discrete area of the body. The symptoms usually last for less than 15 minutes and can persist as long as 24 hours, but never longer. Ministrokes of this sort are often warnings that a full-blown stroke is in the offing. Doctors frequently put people who have had a ministroke on aspirin to prevent a full-blown stroke.

The other circulatory problem called a ministroke is the blockage of one or more small brain arteries. Such a blockage causes the death of a tiny section of brain. Sometimes, with one blockage, no symptoms occur. But as more small arteries become clogged, then memory deficits, clumsiness in walking and trouble using the correct word are examples of symptoms that can arise.

Both kinds of ministrokes are indications for an all-out stroke-prevention program. Blood pressure has to be maintained as close to normal as possible. Smoking must stop. Losing weight, when applicable, is important. If the person has diabetes, strict control of blood sugar is mandatory. Lowering cholesterol is important. And staying as active as possible keeps blood circulating to the brain.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com