What Are the Symptoms of Scleroderma?

Symptoms of scleroderma include thickening, tightening, and hardening of the skin, especially the skin of the fingers and hands; the appearance of hard deposits of calcium in the skin and connective tissues; inflammation of the esophagus, the tube through which saliva, food, and fluids move from the mouth to the stomach; a spotty red rash on the hands and face; spasms of the blood vessels in the fingers and toes (Raynaud's phenomenon), resulting in blanching (whitening) of the skin and pain. If other organs are involved, the disease may cause various other symptoms. Lung involvement can result in shortness of breath,wheezing, cough, fatigue, and difficulty with exertion. Musculoskeletal involvement can result in joint pain, swelling, and stiffness, problems with mobility, and muscle inflammation and tenderness. Involvement of the gastrointestinal system can result in heartburn, gastroesophageal reflux (washing of acid from the stomach into the esophagus, which causes burning, pain, and damage to the esophagus), trouble swallowing, constipation, and liver problems. Inflammation of the heart can lead to congestive heart failure. Kidney involvement can result in severely high blood pressure and kidney filure.

How Is Scleroderma Diagnosed?

Scleroderma may be suspected based on the presence of characteristic symptoms, coupled with knowledge of the individual's personal or family history. A physical examination may reveal red, swollen, shiny, tight skin on the hands, as well as other signs of abnormal collagen production. A number of specific blood tests may be performed in order to demonstrate the presence of an autoimmune and connective tissue disorder. Tests may include antinuclear antibody testing, rheumatoid factor, crythrocyte sedimentation rate, and tests for a variety of other auto-antibodies (antibodies that are directed against the individual's body). Other blood tests may be performed in order to assess the functioning of various organs that may be affected. Biopsies of affected organs may also help make the diagnosis, and specific imaging tests or  function tests may demonstrate the effect that scleroderma is having on specific organ systems.

How Is Scleroderma Treated?

As of 2009, there was no cure for scleroderma. Treatments aimed at calming the overactive immune system and suppressing inflammation throughout the body. Medications used may include nonsteroidal anti-inflammatory agents, steroid drugs, and immunosuppressant agents such as those used to prevent organ rejection after transplant (methotrexate, cyclophosphamide, D-penicillamine). Medications that can dilate blood vessels may be used to treat Raynaud's phenomenon. Other treatments are focused on the specific affected organ systems. In very advanced cases of scleroderma, when lung or kidney damage is severe, lung or kidney transplant may be recommended.

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