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What type of doctor should I see?

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I hope I am wrong about this. For a couple weeks now the tip of my right middle finger has been getting hard. I don't know of any injury to my finger. The hard spot is right next to the nail. The nail almost seems to be pulling away from the hard spot.


I am almost 32 years old and I have 4 young children. I am overwhelmed with the thought of what this small hard spot could be. I have had some minor troubles swallowing and did see a doctor but he felt is must just be stress...


So I am going to a family doctor tomorrow to ask about my finger. But its just the physicians assistant so I don't know if he'll know much. Should I be scheduling something with a Dermatologist? Should I just give this some time to see if it gets worse or goes away? Is there anything else it could be? The skin and nail around it look completely normal except its smooth where the hardness is.

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Dear Bragabit,


Please keep in mind I'm not a doctor and that I'm often wrong about just about everything. Thank you for sharing your concern; I hope our information is able to alleviate some of it.


As I understand it, there are many things that could cause a very small patch of hard skin other than scleroderma and scleroderma would be the most rare (and thus the most unlikely) of all the possible causes.


If the P.A. can't readily identify it, they will probably refer you to a dermatologist. It's possible to get small patches of hard skin just due to dryness or even calluses. Sometimes people who bite their nails also bite the surrounding skin and it grows back thicker and thicker all the time. So to calm your worries, you might want to try to focus on very common causes as much as you can (and yes I do know that is easier said than done!) unless or until the doctor proves it to be something more serious.


And let us know how it all turns out, will you?

Warm Hugs,


Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099


The most important thing in the world to know about scleroderma is sclero.org.

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I think Shelley's piece of advice is what you should focus on. On my opinion she's right even though she seems to doubt it. ;) If you're worried try to contact a dermatologist and he or she will tell you what it is. We'll keep our thumbs up for something minor! :)


Take care,


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Hi Bragabit,


Welcome to the Sclero Forums. I'm glad you've joined us.


I think your decision to start with your PA is a fine one. As already mentioned if there is doubt the PA can ask an opinion of a doctor in their practice or send you onto a specialist.


Do keep us posted.

Warm and gentle hugs,



ISN Support Specialist

International Scleroderma Network (ISN)

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Hi Bragabit,



I have a few questions for you :)


Do you have any other symptoms like joint pain, fatigue, Raynaud's, and GI problems, etc other than the hard spot.


My next question is the pain, fatigue, hard spot, etc severely affecting your quality of life?


What are your swallowing problems?


What tests did you have for the swallowing problem?


Anyhow, If I were you I wouldn't worry too much about the hard spot unless lots of other things are going on.


I have the same thing on the side of my pointer finger and it is not a scleroderma skin issue, I don't know what it is.


To be frank I have other issues like Secondary Raynauds, Severe GERD, gastris, suspected TMJ (severe jaw pain) along with fatigue, joint pain etc that I am more worried about. I worry about them because they interfere with my well being and quality of life. I am actually more annoyed and frustrated by everything than worried though.


So anyhow, my finger is just weird and something to mull over when I am bored.


Now, I didn't decide that it was normal or to be more frank not Scleroderma skin hardening - a rheumatologist did with a sub-specialty in Dermatology.


In your case I suggest you see a Dermatologist. They will give you the most definitive answer and that will probably ease all your worries.


But in the meantime, go ahead and see the PA it won't hurt, they may have some sort of insight, etc. you never know.


Swallowing problems are best diagnosed by a GI specialist so if that continues to bother you I would make an appointment with one.


I wish you the best and hope that this to turns out to be just a spot of dry skin, nothing else :)


Good Luck,



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