What are the symptoms of scleroderma?

Scleroderma is a systemic connective tissue disease that is generally closely related to genetics and autoimmune abnormalities. The symptoms of scleroderma vary significantly at different stages. The early stages of scleroderma are marked by gradual thickening of the skin.

(1) Edema stage

The symptoms include thickening and tightening of the skin, disappearance of wrinkles, non-pitting or pitting edema, pale or yellowish color, low skin temperature, reduced sweating, small cracks on the skin surface, and disappearance of the fat pads on the fingertips. In patients with localized skin lesions, early edema appears on the fingers, back of the hands and face, and later spreads to the upper limbs, neck, shoulders, etc. In patients with diffuse skin lesions, the disease often starts in the trunk and then spreads to the surrounding areas. This period can last for several months.

(2) Hardening period

The skin becomes thickened and hardened, and fibrosis occurs. The fingers and backs of the hands become shiny and taut. In the early stages, the skin may be red and have a waxy luster. There is no sweating, and the hair is sparse. The skin is not easy to pinch. When the facial skin is affected, the face may become tight, the expression may be fixed, the lips may become thinner, and radiating grooves may appear around the mouth. It may be difficult to open the mouth, the nose tip may become pointed, the fingers may gradually become thinner, and the distal fingers may become pointed and shortened. Ulcers may appear, and the flexion and extension of the fingers may be limited. The chest may feel tight. The skin in the affected area may become pigmented and hypopigmented, and the hair is sparse. Skin changes may be limited to the fingers, toes, hands, feet and face, and may extend to the forearms. They may also start from the chest and back and extend to the surrounding areas, involving the upper arms, shoulders, abdomen and legs. The range and severity of the lesions usually reach a peak within 3 years of onset.

(3) Atrophy stage

The skin shrinks and becomes thin like parchment. Sometimes the subcutaneous tissue and muscles may also shrink and harden. The skin lines disappear, the hair falls off, the skin becomes smooth and thin, and close to the bones. Stubborn ulcers are prone to occur on the fingertips and joints. Capillary dilation and subcutaneous tissue calcification may also occur.