Scleroderma Skin Involvement: Overview |
| Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer |
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Overview of Skin Involvement in Systemic Sclerosis (SSc, scleroderma) |
| Skin involvement in systemic sclerosis, which includes both limited/CREST and diffuse scleroderma, can include hair loss, calcium deposits, open sores, swelling, gangrene, changes in skin color, itching, small mouth, swollen or hardened skin on fingers or elsewhere, and dry skin. (Also see: What is Scleroderma?, Types of Scleroderma, and Systemic Sclerosis) |
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. ISN. |
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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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Digital (Finger) Ulcers |
| Digital Ulcers. Systemic scleroderma and Raynaud's can cause painful ulcers on the fingers or toes, which are known as digital ulcers. ISN. |
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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 |
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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| 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. ISN. |
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Hypopigmentation and Hyperpigmentation |
| Hypopigmentation and Hyperpigmentation. Systemic sclerosis (SSc) such as limited or diffuse scleroderma, can cause hyperpigmentation (darkening) and hypopigmention (lightening) of the skin, usually in the areas which have been affected by skin hardening. ISN. |
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Itching (Pruritus) |
| Itching may precede and accompany skin tightening in limited and diffuse systemic sclerosis (lSSc, dSSc, SSc). It is caused by the inflammation, and is a temporary phase. ISN. |
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Lower Extremity Ulcers (Leg and Foot Ulcers) |
| Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy. Lower extremity ulcers are seen in 4% of scleroderma patients and cause pain and morbidity over and above that of the scleroderma. We recommend that scleroderma patients who develop leg ulcers should undergo prothrombotic evaluation. Victoria K. Shanmugam. International Journal of Rheumatology Vol 2010, Article ID 747946. (Hindawi). |
| Lower extremity ulcers in systemic sclerosis: features and response to therapy. Non-digital lower extremity ulcers are a difficult to treat complication of scleroderma seen both in limited and diffuse scleroderma and also in scleroderma sine scleroderma. They contribute to the pain and disability of advanced disease. The etiology (cause) of these ulcers is unknown, but they may reflect chronic vasculopathy. VK Shanmugam. (PubMed) Int J Rheumatol. 2010; 2010: 747946. |
Microstomia: Mouth Involvement in Systemic Scleroderma |
 Microstomia. Systemic scleroderma can cause the mouth area to shrink and harden, which can impair chewing, brushing, flossing, and dental work. When the mouth becomes smaller, it is called "microstomia". ISN. |
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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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Sclerodactyly |
| Sclerodactyly. When fingers and/or toes become tight, stretched, wax-like, and hardened it is called sclerodactyly. ISN. |
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Skin Fibrosis in Systemic Sclerosis |
| Skin Fibrosis. Scleroderma is named after skin fibrosis, which is one of its most common and recognizable symptoms. Skin fibrosis eventually develops in most patients. Sclero means "hard" and derma means "skin". 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 Care |
| 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. ISN. |
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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