Clinical Manifestations
|
- Scleroderma is a kind of skin disease
of connective tissue caused by sclerosis of the skin.
- It is divided into two types: localized
and systemic types.
- Generally, it undergoes three
stages:
Red swelling
Sclerosis
Atrophy
- Advanced stage:
The affected skin will be adhered to the deep tissue
and produce functional disturbance of corresponding
organs.
- Localized scleroderma:
Part of the skin has a sensation of burning heat and
itching, then slightly elevated patches in red or purple
color.
The lesion may be tenioid or elliptical in shape, and
its border is clear with purple halos around it.
The central part is sunken and then the color of patches
will become yellow, brown and pale.
The skin will be indurated and adhesive to the subcutaneous
tissue
Then the cleavage lines will disappear.
Its surface is smooth and then will become atrophied
and thin, and will lose elasticity.
There are branny desquamations and pigmentations on the
skin lesion.
At first the patient may have an unusual feeling or a
sense of itch, then the skin becomes blunt and insensitive.
It often occurs on the head, face, neck and limbs, especially
among the young and middle-aged women
Scleroderma which occurs at the terminal end of limbs
of young women is known as "acrosclerosis."
The course of this disease is chronic.
- Systemic scleroderma:
The skin lesion begins in the face or the skin of the
distant end of limbs, symmetrical in distribution,
then gradually spreads throughout the whole body, or
is generalized from the beginning. It often attacks
the face, limbs, neck and trunk, mostly among middle-aged
women.
At first the skin becomes thick and swollen, its surface
is smooth and cleavage lines disappear.
The skin shows parenchymatous edema (at edema stage),
then gradually becomes adhered to the subcutaneous tissue
It becomes hard, sallow in color and its border is clear
(at sclerosis stage).
Finally, the skin becomes atrophied and thin, and the
hair may fall off.
Sweat obstacle may appear.
The skin and muscle will stick to the bone and become
stiff (at atrophy stage).
At the beginning, there are unusual, tense and itching
sensations locally, and then the sensations become blunt
and gradually or entirely lost
- General constitutional symptoms:
At the beginning:
General malaise
Arthralgia
Loss of weight
Stiff fingers
Spasm of terminal arteries of limbs
At the advanced stage:
Emaciation
Weakness
Low grade fever
The face may be involved and looks awkward
The nose will be sharp and the ears thin
The movement of the mouth and eyes and chewing will be
restricted
If thoracic wall is involved, respiration may be limited
If the four limbs are invaded, the joints will become
stiff and motions limited
If the digestive tract is involved, there will be difficulty
swallowing, with vomiting, nausea, abdominal distention
and diarrhea
If the Lungs are invaded, vital capacity will be reduced.
I
If the Heart is involved, Heart failure will occur.
If the Kidneys are involved, renal hypertension and uremia
may appear
|
