Scleroderma

Signs and Symptoms

Scleroderma can affect everyone differently. The following are some of the general symptoms associated with the condition.

• Skin changes, including:
  

  • Hardening or thickening of your skin, particularly on your hands, arms and face, and occasionally on your trunk and legs
  • Loss of hair over the affected area
  • Change in skin color
  • Ulcers or sores on your fingers

• Swelling or puffiness in your hands or feet, often occurring in the morning.

• Sclerodactyly means shortening of the skin of the fingers and toes. This usually occurs after the initial swelling goes away. You may experience:
  

  • Skin on your fingers and toes becoming hard and shiny
  • Difficulty bending your fingers

• Raynaud's Phenomenon, a condition associated with poor blood flow to fingers and toes. Blood flow decreases because blood vessels in these areas become narrow for a short time in response to cold or emotional stress. Raynaud's Phenomenon may cause:
  

  • Your fingers, toes, tips of your ears, nose or tongue to be very sensitive to cold
  • Your fingers to turn bluish or very pale
  • Your fingers to feel tingly, numb or cold

• Telangiectasia, which occurs when tiny blood vessels become dilated and show through your skin. Small reddish spots may appear on your fingers, palms, face, lips and tongue. These spots are harmless and can be hidden with cosmetics.

• Calcinosis, which occurs when small white calcium lumps form in or under the skin. It is caused by scleroderma and not by too much calcium in your diet. The lumps occasionally break through the skin and leak a chalky, white material. If injured, they may become infected.

• Arthritis and muscle weakness, including:
  

  • Pain, stiffness and swelling
  • General fatigue
  • Muscle weakness, often in your upper arms or thighs

• Digestive problems including poor function of your esophagus and bowels. Symptoms may include:
  

  • Difficulty swallowing
  • Heartburn
  • Bloating
  • Nausea or vomiting
  • Weight loss
  • Diarrhea or constipation

• If the heart and lungs are affected, you may experience:
  

  • Shortness of breath
  • Persistent cough
  • Chest pain

• Kidney problems, such as kidney failure and high blood pressure. Symptoms may include:
  

  • Fatigue
  • Severe headache
  • Shortness of breath
  • Trouble seeing
  • Mental confusion

Diagnosis

If you think that you may have scleroderma, you should visit your doctor immediately. Your doctor will begin by conducting a thorough physical examination and asking about your symptoms and medical history.

Laboratory tests can assist with diagnosis. These usually include blood tests, but occasionally involve tests of lung, heart or digestive function or a biopsy of affected tissues.

Treatment

Drug Therapy

Although there is no current cure for scleroderma, there are many drugs available to help control it, including:

• Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) to treat joint pain and swelling
• Steroids to treat muscle and joint problems
• Antacids to relieve heartburn and intestinal motion and to protect the esophagus and stomach
• Medication to treat high blood pressure
• Drugs to treat Raynaud's phenomenon by increasing blood flow to your fingers and toes

Exercise

Exercise is very important for people with scleroderma because it increases skin and joint flexibility, promotes blood flow and prevents contractures. Your doctor and physical therapist can work with you to develop a healthy exercise plan.

Joint Protection

You can reduce stress and injury to your joints by learning to perform daily activities in a special way. Occupational and physical therapists can teach you ways to relieve pain and increase function through joint protection.

Skin Protection

You can protect your skin from injury by:

• Keeping your body warm to help open blood vessels in your arms, hands, legs and feet
• Using a cold-water humidifier to keep your skin moist
• Avoiding strong detergents or other substances that may irritate your skin
• Trying soaps, creams and bath oils that prevent dry skin
• Leaving calcium deposits alone
• Keeping finger ulcers clean

Stress Management

Living with a chronic disease may cause social and emotional stresses. Talk to your doctor or other members of your health care team about ways to reduce stress and fatigue.