| SKIN INVOLVEMENT: MAIN MENU |
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Scleroderma Skin Involvement: Overview |
| This page was written by Shelley Ensz, and has not yet been medically edited. Scleroderma (SD) affects everyone differently. Just because something is listed here does not mean an individual patient will ever experience it. See Disclaimer. |
 Skin involvement in systemic sclerosis. The fully validated, feasible method ('gold standard') for measuring the dermal skin thickness is the modified Rodnan skin score (mRSS). Parallel method(s) for measuring skin thickness need to be used in the future. (UnBound MedLine) Czirják L. Rheumatology (Oxford) 2008 Oct.:v44-5. (Also see: Skin Fibrosis) |
| Association with other Symptoms |
| Exercise Performance In Systemic Sclerosis: Relationship With Disease Manifestations. Exercise performance is impaired in most SSc patients, at least in those admitted in a referral clinic. The impairment of exercise performance is correlated to lung, heart and skin involvement. L. Ruocco AB0525 EULAR 2007 (Also see: Effects of SSc, Cardiac and Pulmonary Involvement) |
| Organ Involvement-Induced Disability In Systemic Sclerosis (SSc) . SSc-related disability is clinically significant and is mostly related to joint, cutaneous and cardio-pulmonary involvement, as well as to the disease-induced fatigue. C. Mihai. AB0514 EULAR 2007. (Also see: Skeletal, Cardiac and Pulmonary Involvement) |
| Alopecia (Hair Loss) |
| Alopecia (hair loss) may occur with scleroderma, if it affects the scalp. It may also occur due to the side effects of some treatments for Scleroderma symptoms, such as chemotherapy. |
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| Calcinosis |
| Calcinosis. The systemic forms of scleroderma can cause small white calcium lumps to form under the skin on fingers or other areas of the body. This is called Calcinosis. The lumps may break through the skin and leak a chalky white liquid. ISN. |
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| Collagen, Face Lifts and Scleroderma |
| Collagen, Face Lifts, and Scleroderma. Collagen injections should be used with caution in people who have had certain autoimmune diseases. ISN. |
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| Fingernails, Nailfolds, and Cuticles |
| Fingernails, Nailfolds, and Cuticles. The systemic forms of scleroderma can cause the fingernails to become smaller, and cuticles to become hard or rough. But because there are so many possible causes of poor fingernail or cuticle condition, they are not part of the diagnostic criteria for any form of scleroderma. ISN. |
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| Digital (Finger) Ulcers |
| Digital (Finger) Ulcers are sores caused by an interruption in blood supply from Raynaud's. |
| Edema (Swelling) |
| In the initial stages, the systemic forms of scleroderma may cause edema (swelling) in the fingers. |
| High-frequency ultrasound of skin involvement in systemic sclerosis reflects oedema, extension and severity in early disease. In SSc patients with short disease duration, high-frequency ultrasound can identify the oedematous phase that may precede palpable skin involvement and may thus be useful to identify patients with diffuse skin involvement very early in the disease process. Ultrasound measurements also reflect the severity of the overall skin involvement. Hesselstrand R. (PubMed) Rheumatology (Oxford). 2008 Jan;47(1):84-7. |
| Linear morphea presenting as acquired unilateral edema. We describe a 2-year-old African-American boy with a 4-month history of gradually worsening unilateral edema that was initially noted on his left hand and then approximately 2 weeks later on his left lower extremity. Fiala KH. Pediatr Dermatol. 2007 Mar-Apr;24(2):147-50. (Also see: Morphea) |
| Elbow Tip Pain |
| Scleroderma Elbow Tip Pains "Scleroderma is a chronic condition that causes inflammation and thickening of the skin. A common area of involvement of this condition is the skin over the tips of the elbows (the olecranon area). When this skin is involved, it can lead to troublesome irritation of the tips of the elbows with tenderness noted when any pressure is applied." MedicineNet |
| Facial Involvement |
| The rehabilitation of facial involvement in systemic sclerosis (SSc): efficacy of the combination of connective tissue massage, Kabat's technique and kinesitherapy: a randomized controlled trial. In SSc face involvement causes functional loss as well as aesthetic changes and loss of the self-image. The combination of connective tissue massage, Kabat's technique, kinesitherapy and home-based exercises is more effective than a home exercise program alone in the rehabilitative treatment of SSc facial involvement. S Maddali-Bongi. (PubMed) Rheumatol Int. 2010 Mar 18. |
| Fibrosis |
| Skin Fibrosis, which is a hardening of the skin, can happen very rapidly (within a few weeks of onset) or very slowly, over the course of many years. Skin fibrosis normally worsens during the first two to five years, and then improves. Once the skin softens, it seldom goes through a second hardening phase. If the Scleroderma progresses uninterrupted, the fingers may harden, often causing Flexion (Joint) Contractures. (Also see: Sclerodactyly) ISN. |
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| Gangrene (Death of Tissue) |
| Gangrene and Amputations. Severe cases of scleroderma and Raynaud's may cause a total lack of blood supply to the extremities. When this happens, necrosis (death of tissue) and gangrene may set in, sometimes making it necessary to have the affected part(s) amputated. Gangrene occurs more frequently among scleroderma patients who smoke or use caffeine, because such substances further constrict blood vessels. ISN. |
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| Hyperpigmentation |
| Scleroderma can cause hyperpigmentation (darkening) of the skin, usually in the areas which have been affected by skin hardening. Cosmetically, this can be covered up with such products as Dermablend ® Corrective Cosmetics. |
| Symptoms Include Dark Skin & Numbness in the Lower Extremities. Typical symptoms of scleroderma involve coldness and numbness in the phalanges or fingers and toes, with hyper-pigmentation. Kay Jenkins. EHow. |
| Ultraviolet Light Therapy Is as Beneficial for Darker Skin as Lighter Skin. An analysis of more than 100 patients has confirmed for the first time that darker-skinned patients benefit as those with lighter skin when given light therapy for morphea and related diseases. Newswise. UT Southwestern Medical Center. 07/08/08. (Also see: Morphea) |
| Do You Have an Autoimmune Disease? Why You Should Beware of the Sun. Some people with scleroderma have hyperpigmentation of the skin that is made worse by sun exposure. Arthritis Today. 02/28/07. (Also see: Autoimmunity) |
| Hyperpigmentation associated with minocycline therapy. In one study, hyperpigmentation occurred in 41% of patients with rheumatoid arthritis who had been taking minocycline for more than 3 months (median onset 12 months).2 When not extensive, hyperpigmentation may at least partly regress after minocycline therapy is discontinued. Alexandrite laser therapy has been effective in treating minocycline-induced hyperpigmentation without scarring or hypopigmentation. Soumya Chatterjee. CMAJ • January 30, 2007; 176 (3). |
| Itching |
| In Diffuse Scleroderma, itching may precede skin tightening, and is a temporary phase. The prescription drug Atarax (generic name: Hydroxyzine Hydrochloride) may help in this situation. (1) |
| Consult your doctor right away if you develop sudden or severe itching, as this may be a symptom of other things, such as kidney failure or liver disease, which often occur in systemic scleroderma. |
| What's Your I.Q.? (Itch Quotient?) Lanacane Itch Information Center |
| Itching (Pruritus). In those with generalized pruritus, or itching all over, a systemic disease may be the cause in about 50 percent of people. Medications that can cause itching include Plaquenil (hydroxychloroquine), aspirin, NSAIDs, and any of a large number of medications that cause itching by affecting the liver. Non-specific treatments for pruritus, such as topical steroid creams and oral antihistamines, as well as good skin care and moisturizing, can provide much relief for people with generalized pruritus. Daniel More, MD, About.com Updated: January 16, 2009. |
| The association of pruritus (itching) with quality of life (QoL) and disability in systemic sclerosis (SSc). Pruritus is common and associated with QoL in SSc. More attention to pruritus in SSc is needed, including its measurement, etiology, trajectory, and potential methods for intervention. G El-Baalbeki. (PubMed) Arthritis Care Res (Hoboken). 2010 May 12. |
| Diphenhydramine. Diphenhydramine is an oral antihistamine (e.g. Benadryl or generic equivalents) used for treating allergic reactions. It helps to stimulate changes within the cells that lead to sneezing, itching, and increased mucus production. O. Ogbru. MedinceNet.com. |
| Microstomia |
| Microstomia is the term used when fibrosis causes the skin around the face and mouth area to become hard and tight. Movement of the tongue may be impaired as well. See Scleroderma Photos. |
| Neck Sign |
| The Neck Sign is a distinctive pattern of yellow-brown plaque with beading and ridging. See Scleroderma Photos |
| Raynaud's |
| Raynaud's causes blood vessel spasms, which can cause painful coldness, color changes, numbness and tingling. ISN. |
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| Rashes |
| Skin rashes may be caused by various autoimmune diseases such as lupus or dermatomyositis and in some skin conditions which are similar to Scleroderma. But before becoming unduly concerned, rule out the most common causes. |
| Skin Rashes and Other Changes.The location, appearance and color of a rash will help your doctor make the diagnosis. Look for care suggestions on this chart for common rashes. familydoctor.org |
| Skin Rashes: Self-Care Flowchart. (Excellent & Easy to Use) |
| Chronic hives: What causes them? Occasionally, chronic hives can be associated with a serious, underlying medical condition, such as lupus, connective tissue disease, thyroid disorder and cancer. So it's important to have chronic hives evaluated by a doctor. MayoClinic. 04/12/07. |
| Sclerodactyly |
| Sclerodactyly. When the fingers become tight, stretched, wax-like, and hardened it is called sclerodactyly. ISN. |
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| Telangiectasia |
| Telangiectasia may appear on the hands or face. These are tiny red dots, which are caused by blood vessels dilating near the surface of the skin. They are harmless, and can be covered up with makeup if need be. ISN. |
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| Wound Healing |
| Wound Healing can be a real challenge for many scleroderma patients. Wounds include accidental cuts and abrasions as well as microvascular damage such as digital ulcers. Any wound that does not show improvement after a couple of days should be brought to your doctor's attention. |
| Xerosis (Dry Skin) |
| Xerosis may occur from Scleroderma causing the skin to become excessively dry. Very mild soaps and lotions (often baby products) are recommended. ISN. |
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