Scleroderma, a chronic systemic autoimmune disease, can cause a variety of symptoms involving many parts of the body. Perhaps the most distinct symptoms of scleroderma are those that affect the skin. Patients with this disease experience skin thickening, tightening, and hardness. Other symptoms of scleroderma may develop when the underlying disease process infiltrates the esophagus, the kidneys, the lungs, or the heart. Although the symptoms resulting from the involvement of the internal organs are nonspecific, it is important to identify these symptoms because they can herald the development of serious complications.
The most obvious symptoms of scleroderma are the skin abnormalities that it causes. The word scleroderma itself is derived from the Greek words “skleros” meaning hard and “derma” meaning skin. The skin of patients with scleroderma is tight and thickened compared to normal skin. Some patients only have limited skin problems, while others can have diffuse symptoms affecting all of their skin.
In addition to tightening and hardening, scleroderma symptoms can include other skin abnormalities. Skin tightening can lead to sclerodactyly, which is a condition characterized by having the fingers stuck in a flexed position. Some patients with scleroderma develop a condition called “en coup de saber,” which causes skin thickening in a vertical strip of the forehead, and can lead to abnormalities in the appearance of the face.
Other symptoms of scleroderma result from damage to the internal organs. The esophagus, which is the tube carrying food from the mouth to the stomach, is often affected by this systemic disease. Patients can experience acid reflux, which is characterized by pain and burning in the chest due to the regurgitation of material from the stomach. Other symptoms such as pain with swallowing, difficulty in swallowing hard foods, and regurgitation of food are common if the disease process infiltrates the esophagus.
The kidneys can also be affected by scleroderma. Dysfunction of the kidneys is often asymptomatic, but extensive renal involvement can result in hypertension, or high blood pressure. Symptoms of severely elevated blood pressure can include headache, vision loss, and chest pain.
Involvement of scleroderma in the lungs can cause symptoms such as shortness of breath, cough, and exercise intolerance. Patients might feel as though they cannot catch their breath when they are walking. Although these symptoms are nonspecific and can be caused by many diseases, identification of pulmonary scleroderma symptoms is important because progression of this lung disease can be fatal.
Some patients with scleroderma also have problems with their hearts. Abnormalities in the cardiac conduction system can lead to symptoms such as palpitations and fainting. If the scleroderma disease process affects the muscle of the heart, patients can experience chest pain, swelling of the feet, and a decreased ability to exercise.
