From Current Rheumatology (McGraw-Hill, 2007)
Most frequent symptoms in (descending order):
Raynaud phenomenon
gastroesophageal reflux with or without dysmotility
skin changes
swollen fingers
arthralgias
Other factors:
* A negative antinuclear antibody test makes the diagnosis of scleroderma very unlikely.
* The degree of skin involvement is highly variable. Many patients with limited scleroderma have only subtle cutaneous findings (eg, mild sclerodactyly).
* The available diagnostic criteria do not include many patients with milder forms of scleroderma.
* Some patients may have overlapping clinical features with other systemic autoimmune rheumatic disorders such as polymyositis/dermatomyositis, Sjögren syndrome, systemic lupus erythematosus, and rheumatoid arthritis.
From Uptodate (On campus access only):
See article entitled "Diagnosis and differential diagnosis of systemic sclerosis (scleroderma) in adults"
For management of renal crisis, see article on "Scleroderma renal crisis"
