Scleroderma (systemic sclerosis) is a rheumatologic disorder that can be mistaken for rheumatoid arthritis (RA) or mixed connective tissue disease. Accurate diagnosis influences assessment of the patient’s prognosis as well as the choice of management.
What is the skin pinch test for scleroderma?
The normal skin fold of a healthy person can be “pinched” over the middle phalanx (left), but in a patient with SSc (right), no skin fold can be pinched over the middle phalanx. A patient who has none of these features rarely has SSc.
What is the distinguishing hallmark in a patient with scleroderma?
Raynaud phenomenon and scleroderma (hardening of the skin) are the clinical hallmarks of the disease.
Is scleroderma like rheumatoid arthritis?
Scleroderma “is different from lupus or rheumatoid arthritis, which are often treated the same way through a hierarchy of medications.” With scleroderma, he says, your treatment plan will be “custom-made based on what your needs are.”
Can scleroderma be misdiagnosed as rheumatoid arthritis Related Questions
How do you rule out scleroderma?
To diagnose scleroderma, a doctor usually begins by asking you about your symptoms, health, and medical history. The doctor will also examine your skin for signs of hardening and thickening. If you have hard, thickened skin, a dermatologist may perform a skin biopsy to help diagnose you.
What were your first signs of scleroderma?
Hard, thickening, or tight skin. This trait is what gives scleroderma its name. Hair loss and less sweating. Dry skin and itch. Skin color changes. Salt-and-pepper look to the skin. Stiff joints and difficulty moving them. Muscle shortening and weakness. Loss of tissue beneath the skin.
What is the 6 minute walk test for scleroderma?
The 6-min walk test (6MWT) is a simple standardized measure of the distance walked during a defined period of time which assesses the submaximal level of functional capacity.
What is the autoimmune marker for scleroderma?
Blood tests: Elevated levels of immune factors, known as antinuclear antibodies, are found in 95% of patients with scleroderma. Although these antibodies are also present in other autoimmune diseases such as lupus, testing for them in potential scleroderma patients is helpful in assisting with an accurate diagnosis.
What do your hands look like when you have scleroderma?
The most classic symptom of scleroderma is a type of skin tightening called sclerodactyly. The initial stages of the disease involves swelling of the fingers. Later, as the connective tissue becomes fibrotic, skin on the fingers and toes becomes hard and shiny.
What is the gold standard for diagnosing scleroderma?
ANA: Antinuclear Antibody Assay Antinuclear antibody (ANA) testing is the most important blood test to screen for scleroderma and other connective tissue diseases.
What is the most common presenting feature of scleroderma?
Scleroderma is a chronic, autoimmune connective tissue disorder that is primarily characterized by thickening and hardening of the skin and other tissue. In localized scleroderma, the skin is the main organ system involved and muscles and bones may or may not be.
What is the gold standard for scleroderma?
Nailfold capillaroscopy is a method showing importance for the evaluation of microcirculation in patients with RP. This imaging technique is easy to repeat, non-invasive and inexpensive. It has become a gold standard in diagnostic process of scleroderma.
Is scleroderma worse than RA?
The observation that patients with SSc had poorer quality of life than patients with RA or SLE may reflect the different disease patterns and severity, with SSc typically having a more progressive course, disfiguring skin disease, and pronounced psychological stress.
What can be misdiagnosed as scleroderma?
Like many autoimmune diseases, systemic sclerosis, or scleroderma, can be a challenge to diagnose because its symptoms are varied, can range from mild to debilitating, and often resemble those of other conditions, such as systemic lupus erythematosus and rheumatoid arthritis.
What can mimic scleroderma?
Eosinophilic fasciitis has a tendency to involve the trunk and extremities while sparing the hands and feet. The condition causes skin thickening similar to scleroderma.
Does scleroderma show up on bloodwork?
A blood test alone cannot diagnose scleroderma. Depending on the clinical situation, additional tests may be done, such as: Pulmonary function tests or breathing tests to measure how well the lungs are working. CT chest scan may also be ordered to evaluate the extent of lung involvement.
How does a rheumatologist diagnose scleroderma?
A rheumatologist can usually make the diagnosis based on an examination and evaluation of blood tests that support the diagnosis. A dermatologist can also make the diagnosis based on specific features on examination of the skin.
Where does scleroderma usually start?
Diffuse cutaneous scleroderma comes on suddenly, usually with skin thickening on your fingers or toes. The skin thickening then spreads to the rest of your body above the elbows and/or knees. This type can damage your internal organs, such as: Anywhere along your digestive system.
What is the average age at onset of scleroderma?
Age: Most localized types of scleroderma show up before age 40, and systemic types of scleroderma are typically diagnosed between ages 30 and 50.
What does scleroderma pain feel like?
Symptoms can include: Tight skin or swollen joints. Joint pain or tenderness. Muscle fatigue and weakness or aching.