Medical Health Encyclopedia

Course of Typical Skin Changes and Hardening. The primary symptoms of scleroderma occur in the skin. They often take the following course:

• Typically, pitted scars appear first on the hands. The skin begins to thicken and harden on the hands, feet, and face. The fingers may swell. (The condition is called sclerodactylia or acrosclerosis.) (Patients with diffuse scleroderma may have whole hand swelling before the skin significantly thickens.)
• Thickened or hardened patches on other areas of the body may also develop. (Their appearance on the trunk and near the elbows or knees tends to indicate a more severe condition.)
• For the first two or three years, the skin continues to thicken and to feel puffy.
• Then this process stops and can even recede. The skin may soften.
• As the disease progresses further, however, the skin loses its elasticity and becomes shiny as it stretches across the underlying bone, particularly in the fingers, toes, and around the mouth.
• Eventually, in severe cases, fingers may lose mobility and be difficult to bend. The hands and feet may curl from the tautness of the skin. It may be difficult to open the mouth widely.

Click the icon to see an image of sclerodactyly.

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Other Skin Changes. The following skin symptoms may also occur:

• Flat red marks, known as telangiectasis, may appear in various locations, usually the face, palms, lips, or inside the mouth.

Click the icon to see an image of telangiectasia.

• In calcinosis, small white lumps form beneath the skin, sometimes oozing a white substance resembling toothpaste, which can lead to infections.
• The base of the fingernails may show capillary (small blood vessel) loss in some places and capillary dilation in others, an indication that organ involvement may be present.
• The entire surface of the skin may darken over time and contain patches of abnormally pale skin.
• Hair loss may occur.
• About one percent of patients have Sjogrens syndrome, a group of symptoms that include dry eyes and dry mucous membranes (such as those in the mouth).
• Inside the mouth, scleroderma can also cause gum changes that impair healing.

Bone and Muscular Symptoms