Scleroderma Symptoms and Signs

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is scleroderma?

Scleroderma is a systemic autoimmune disease that features skin inflammation but can also affect internal organs. Symptoms of scleroderma, therefore, vary widely from patient to patient.

Common scleroderma symptoms and signs

The key abnormality of scleroderma is inflammation of the skin that can be manifest as redness, swelling, pain, and thickness of the involved skin areas. Eventually, this inflammation can lead to firmness and hardness of the skin. Typical areas of involvement include your hands, feet, face, and neck. However, any skin site can be affected.

Another common symptom of scleroderma is color changes in your fingers in response to exposure to cold and sometimes to heat and emotional situations. This response is a result of local spasm of blood vessels, typically in your hands and feet and is referred to as Raynaud's phenomenon. It can cause the fingers and toes (sometimes nose and ears) to become white, then blue, then red after cold exposures. Raynaud's phenomenon can be mild and not require any treatment, but it can also be severe and cause ulcerations of your fingertips and toes, requiring medications and even surgical treatments. Often Raynaud's phenomenon is the early symptom of scleroderma.

Patients with scleroderma commonly have heartburn because the lower esophagus is weakened, allowing stomach acid to reflux back into the esophagus and mouth. This can lead to stricture of the esophagus and difficulty swallowing as well as irritation of the throat and vocal cords.

Tiny capillary widenings on the fingers, face, tongue, lips, and chest are also common in patients with scleroderma and are referred to as telangiectasias. Rarely, they can be in the stomach. Telangiectasias can occasionally require laser treatments.

The bowels are weakened when affected by scleroderma and this can lead to constipation, diarrhea, bloating, and abdominal pain.

Less common scleroderma symptoms and signs

Less common symptoms of scleroderma are calcium deposits (calcinosis) in your fingers, elbow tips, hips and elsewhere, shortness of breath from lung involvement, weakness from muscle involvement, difficulty breathing with exertion from pulmonary artery hypertension, and high blood pressure from kidney involvement.

Medically reviewed by Norman Levine, MD; American Board of Dermatology

REFERENCE:

Klippel, J. H., et al. Primer on the Rheumatic Diseases, 13th Edition, Springer, 2008.

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