What are the symptoms of scleroderma?
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Scleroderma can cause a range of symptoms affecting many different parts of your body:
- Sensitivity to the cold.
- Changes in the skin.
- Pain or stiffness in the joints or muscles.
- Digestive problems.
Sensitivity to the cold (Raynaud’s phenomenon)
Most people with systemic sclerosis develop an unusual sensitivity to the cold, known as Raynaud’s phenomenon. Your fingers or toes turn white then blue in the cold. Just walking into a cold room or reaching into the fridge can make this happen. The colour returns to normal as your hands or feet warm up.
Raynaud’s phenomenon is caused by your blood vessels narrowing (constricting), which reduces the blood supply to your fingers or toes. Stressful situations can also cause the blood supply in your hands to reduce and provoke a Raynaud’s attack.
It’s possible to have Raynaud’s without having scleroderma, but most people with the systemic form of scleroderma will have symptoms of Raynaud’s at some time during their illness, and it’s often one of the first symptoms to appear.
Changes in the skin
The most common changes include:
- the skin on your hands, arms and face thickening and hardening – about 95% of people with scleroderma will notice these changes
- your hands and/or feet swelling, especially in the morning
- shiny skin, without its usual creases
- the skin on your face stiffening, making it difficult to open your mouth wide, and sometimes your lips becoming thinner
- small red blood spots (called telangiectasia) on your face, hands and arms
Less frequently, or later on in the condition, symptoms can include:
- thinning of the pads at your finger tips
- peeling, cracking or open sores (ulcers) in your skin and flesh over your fingertips, caused by poor blood supply
- small, white chalky lumps under your skin (calcinosis), caused by calcium deposits, often on your fingertips
Pain or stiffness in the joints or muscles
Scleroderma can cause inflammation in your joints. This may lead to:
Muscle weakness is sometimes a symptom of scleroderma, and about 1 person in 5 with scleroderma will also have symptoms of a second rheumatic condition such as rheumatoid arthritis, lupus or Sjögren’s syndrome.
In established scleroderma, your joints can tighten into a bent position because the skin and tissues surrounding your joints becomes tighter. These are called
contractures and can occur in your fingers or elsewhere in your body.
The systemic form of scleroderma can affect the connective tissue of your internal organs, for example your digestive system, resulting in:
- difficulty swallowing, caused by the weakening of the muscles in your gullet (oesophagus)
- heartburn, caused by acid leaking upwards from your stomach into the lower part of your oesophagus
Most people with systemic sclerosis have some problems with swallowing or heartburn. Less often, other parts of your bowel may be affected, leading to symptoms such as:
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- abdominal bloating