Scleroderma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

Skin

Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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  Panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
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  Necrosis of distal finger in a patient with panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
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  Panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
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  Skin: Scleroderma; shoulders & back
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  Skin: Scleroderma in crest syndrome; calcinosis at elbow
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  Hands: Scleroderma,
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  Hand: Scleroderma, finger, posterior nail fold
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  Skin: Scleroderma, chest, salt and pepper pigmentation
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  Leg: Morphea, circumscribed scleroderma; age 19
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  Face: Morphea, circumscribed scleroderma
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  Clinical appearance of acrosclerotic piece-meal necrosis of the thumb in a patient with systemic sclerosis.
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  Left arm of Scleroderma patient, showing skin lesions
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  Morphea

Lungs

Some impairment in lung function is almost universally seen in patients with diffuse scleroderma on pulmonary function testing; however, it does not necessarily cause symptoms, such as shortness of breath. Some patients can develop pulmonary hypertension, or elevation in the pressures of the pulmonary arteries. This can be progressive, and lead to right sided heart failure. The earliest manifestation of this may be a decreased diffusion capacity on pulmonary function testing.

Other pulmonary complications in more advanced disease include aspiration pneumonia, pulmonary hemorrhage and pneumothorax.