Scleroderma affects each person differently. Symptoms may vary depending on the areas affected by the disease, and the severity of any given symptom can vary depending on the individual.

The symptoms listed below can occur in patients with scleroderma. Not all patients with scleroderma will experience all of these conditions. Many of the symptoms can be caused by several factors, so their appearance should not always be viewed as a change in your scleroderma. Concerns about a new symptom or a change in the severity of a symptom should always be discussed with your physician.

The first symptom for patients with scleroderma is usually a thickening or hardening of the skin. The hands, face and arms are most often affected, but it may strike in other parts of the body as well. Thickening of the skin usually begins at the tips of the finger and moves toward the knuckles.

Initially, the patient experiences tightness and puffiness or slight swelling in the skin on both sides of the body. As the disease progresses, the skin becomes shiny and smooth, and the normal skin creases disappear. After weeks or months, the swelling may be replaced with a hardening of the skin.

Sclerodactyly is the medical term for "hardening of the skin on the fingers." As the disease progressively affects the skin on the fingers, patients have difficulty bending them.

All patients with scleroderma experience a blood vessel condition called Raynaud's phenomenon, in which the small blood vessels constrict or get smaller. Vessel constriction prevents proper blood flow to the affected area, and as a result, the skin turns pale and then blue. When the response subsides and blood flow returns, the skin turns red. The fingers, ears, and nose are most affected by this condition. The Raynaud response is usually triggered by cold and/or stress.

Some patients with scleroderma may develop calcinosis late in the course of the disease. In calcinosis, small mineral deposits form under the skin, usually over pressure points such as the buttocks, knees, and elbows. Calcinosis is due to the disease process and is not due to too much calcium in the diet. In some cases, the deposits can ooze calcium, creating a risk for infection.

Many patients with scleroderma develop telangiectasia, a condition in which the small blood vessels dilate or enlarge. This leads to the appearance of flat red marks on the hands, face, and tongue. The spots are not harmful and can often be hidden with cosmetics.

Joint pain and muscle stiffness frequently occurs with scleroderma. Patients may experience warmth and tenderness in the joints similar to that experienced in rheumatoid arthritis. Muscle weakness, especially in the upper arms and thighs, and fatigue may also occur.

About one percent of patients with scleroderma experiences a mucous membrane disorder known as Sjögren's syndrome. With this condition patients typically experience dryness of the eyes, mouth, and other mucous membranes.

Patients with scleroderma may experience other symptoms depending on which organs are affected. The esophagus is affected in most people who have diffuse or limited scleroderma. When the disease strikes the esophagus, patients experience heartburn and problems in swallowing. Other symptoms related to the gastrointestinal system are diarrhea and constipation. Shortness of breath, dizziness, persistent cough, and chest pain can suggest that the disease has affected the heart and lungs. High blood pressure, headache, visual problems, and mental confusion may indicate that the kidneys have been affected by scleroderma.

References

First published April 1, 2000
Last updated October 10, 2003
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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