Systemic scleroderma
(Redirected from Diffuse cutaneous systemic sclerosis)
A chronic connective tissue disease



Systemic scleroderma, also known as systemic sclerosis, is a chronic autoimmune disease characterized by fibrosis (thickening and hardening) of the skin and internal organs. It is a complex condition that affects the connective tissue and can lead to significant morbidity and mortality.
Pathophysiology[edit | edit source]
Systemic scleroderma is primarily characterized by excessive collagen deposition in the skin and other organs. The exact cause of the disease is unknown, but it is believed to involve a combination of genetic, environmental, and immunological factors. The disease process involves autoimmunity, vascular dysfunction, and fibrosis.
Autoimmunity[edit | edit source]
In systemic scleroderma, the immune system mistakenly attacks the body's own tissues, leading to inflammation and fibrosis. Autoantibodies such as anti-centromere and anti-Scl-70 are often present in patients and can be used as markers for diagnosis.
Vascular Dysfunction[edit | edit source]
Vascular abnormalities are a hallmark of systemic scleroderma. Patients often experience Raynaud's phenomenon, which is characterized by episodic vasospasm of the fingers and toes. Over time, persistent vascular damage can lead to digital ulcers and pulmonary arterial hypertension.
Fibrosis[edit | edit source]
Fibrosis in systemic scleroderma results from the overproduction of collagen by fibroblasts. This leads to thickening and hardening of the skin and can affect internal organs such as the lungs, heart, kidneys, and gastrointestinal tract.
Clinical Features[edit | edit source]
The clinical presentation of systemic scleroderma is highly variable and can range from mild skin involvement to severe multi-organ disease.
Skin Involvement[edit | edit source]
The skin changes in systemic scleroderma typically begin with edema and progress to sclerosis. The skin becomes tight, shiny, and may restrict movement. Telangiectasia and calcinosis can also occur.
Musculoskeletal System[edit | edit source]
Patients may experience joint pain, stiffness, and muscle weakness. Arthralgia and myopathy are common symptoms.
Pulmonary Involvement[edit | edit source]
Lung involvement is a major cause of morbidity and mortality in systemic scleroderma. Interstitial lung disease and pulmonary arterial hypertension are common complications.
Gastrointestinal Tract[edit | edit source]
The gastrointestinal tract can be affected at any level, leading to symptoms such as dysphagia, gastroesophageal reflux disease, and malabsorption.
Renal Involvement[edit | edit source]
Renal crisis, characterized by sudden onset of hypertension and renal failure, is a serious complication of systemic scleroderma.
Diagnosis[edit | edit source]
Diagnosis of systemic scleroderma is based on clinical features, laboratory tests, and imaging studies. The presence of specific autoantibodies can aid in diagnosis. Skin biopsy may be performed to confirm the diagnosis.
Treatment[edit | edit source]
There is no cure for systemic scleroderma, but treatment focuses on managing symptoms and preventing complications. Immunosuppressive therapy, vasodilators, and antifibrotic agents are commonly used. Physical therapy and occupational therapy can help maintain mobility and function.
Prognosis[edit | edit source]
The prognosis of systemic scleroderma varies depending on the extent of organ involvement and the presence of complications. Early diagnosis and treatment can improve outcomes.
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Contributors: Kondreddy Naveen, Prab R. Tumpati, MD