Arthritis Q&A by Dr. Shiel

My mother has a condition in which her fingers turn completely white--especially during the winter--and when the blood returns to her fingers, they tingle. A rheumatologist told her today that she possibly has scleroderma. What is the prognosis and treatment for this disease?

Answer:

The condition you are describing in your mother's fingers is compatible with Raynaud's phenomenon. Raynaud's phenomenon is a condition resulting in discoloration of the fingers and/or the toes after exposure to changes in temperature (cold or hot) or emotional events. Skin discoloration occurs because an abnormal spasm of the blood vessels causes a diminished blood supply to the local tissues.

Raynaud's phenomenon is particularly common in patients with scleroderma, although it may occur with other diseases or by itself. Scleroderma is an autoimmune disease of connective tissue. Autoimmune diseases are diseases which occur when the body's tissues are attacked by its own immune system. Scleroderma is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body. This leads to thickness and firmness of involved areas, most frequently in the fingers. The cause of scleroderma is not known.

The prognosis of patients with scleroderma varies greatly from patient to patient and depends primarily on whether or not internal organs are affected substantially. The prognosis for a patient with scleroderma is optimized by close monitoring of overall health status and treatment of complications, especially elevated blood pressure. Recent data indicates that the critical period in which internal organs are at risk for damage is generally within the first three years after involvement of the skin is noted. This means that patients can be reassured that their risk of organ-threatening complications is significantly less after three years with manifestations in the skin.

Thank you for your question.


Last Editorial Review: 1/31/2011