Diffuse Cutaneous Scleroderma (dcSSc - Systemic Sclerosis)

Symptoms

  • Affects greater area of skin than lcSSc
  • Proximal and distal
  • More rapidly progressive,
  • Tightening/thickened fingers
  • Telangiectasias, raynauds→ finger hypoperfusion and pain in cold
  • Sub-cu nodules less common
  • GERD, which can lead to Barretts (and then cancer), scarring; also dysphagia
  • Internal organs involvement includes: sob from interstitial lung dz, but plum htn less common
  • Athralgias & myalgias
  • Scleroderma renal crisis; pericarditis

Physical Exam Findings

  • Telangiectasias
  • Raynauds → fingers blanch/hurt when exposed to cold temp
  • Skin thickening/tightness
  • Dry crackles if interstitial lung disease

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