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That's Eczema, Not Early Sclero

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First, according to this website, if you have at least 2 of CREST then you have CREST and somewhere I read if you have 3 of ABCDCREST you have systemic sclerosis with a 90-something % accuracy. I have Raynaud's (with positive nailfold capillary test), esophageal, and according to the ABCDCREST, the S in CREST can be either sclerodactyly or bilateral non pitting edema of the fingers, especially in mornings...which I also have. Anyways, that said....

So, I'm at my primary care physician (internal medicine though) and I asked him about the skin on the top of my hands being tight and shiny/smooth, sucked in between hand bones, pulling over wrist bone and swollen fingers (swollen worse in the mornings). Well, there is some hardness on my knuckles with darker skin and it's dry. He says I have eczema and prescribed some lotion for it. Insisting it's causing both the dry/tough knuckles and the smooth tight skin ∧ saying my fingers don't have much edema in them (it's 3pm and if I'm freezing cold for a long enough period of time, some of the swelling reduces, but in the morning...I can't even interlock my fingers and they ache...as it gets warmer, it's hard to write or...don't laugh....golf).

I looked it up. Eczema begins with intense itching, rash shows up later. Diagnosed by finding out if there's severe itching, how the scaly rash appeared (intense itching then rash), and is identified by a characteristic scaly rash (which they can scrape off and test to make sure it's not a fungus before diagnosing eczema). He never asked about itching, I never said itch, it's farthest thing from scaly!

SO, he also said that my fingers would be much more swollen and skin on top of hands and fingers would be so tight I wouldn't hardly be able to move. True...but... when someone has scleroderma....does your skin just automatically go from normal, healthy, very elastic skin to overnight sclerodactyly with contractures or can it take months of fingers swollen (especially in the morning) and slow tightening? Especially if you don't have the fast progressing type?

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Ok, the ABCDCREST article is on the ISN website CREST syndrome

Also, the last few times I've seen my mom, when she holds my hand, she always asks me why my skin feels thick and hard. I don't think it feels hard, I think my fingers feel think and the palm of my hand. BUT since she's my mom, I guess she would notice when she touches my hands that they feel different.

I also have tissue loss in the finger pads, but no calcinosis.

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My goodness, I would see a different doctor. Frankly it sounds like he may not even be familiar with CREST. Do you see a rheumatologist?


You are right about the gradual onset for many with the skin tightening. I really would seek other medical support.


I'm really sorry you are dealing with this.

Warm and gentle hugs,



ISN Support Specialist

International Scleroderma Network (ISN)

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I agree with Sweet... get a second opinion. You might talk to a doctor who knows about Scleroderma.


I have diffuse and for my skin progression I had eczema for a few years and it was itchy, but this was pre-diagnosis. Years later as I was being diagnosed my doctors said I looked swollen. Meds calmed things a bit but now its definitely tightening. My hands are weak and ache. PT has helped prevent them from curling.


Good Luck,



You can deprive the body but the soul needs chocolate

my HMO makes me wear a helmet...

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You don't look that stupid!!!! You aren't.

I think what's happening to you happens to a lot of people. Doctors don't want to diagnose scleroderma. For years the play book was so grim that it's a diagnosis that could wait. So many stories sound like yours, "No, that's from getting old, that's from showering too much, if you had sclero you'd have..."

But today things are changing and their are many good therapy options that you might want to pursue and a diagnosis will help you get that treatment.

See another doctor and don't give up. Thank goodness you're smart enough to research yourself.

michael in florida

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