Symptoms:

Some types of scleroderma affect only the skin, while others affect the whole body.

• Localized scleroderma usually affects only the skin on the hands and face. It develops slowly, and rarely, if ever, spreads throughout the body or causes serious complications.
• Systemic scleroderma, or sclerosis, may affect large areas of skin and organs such as the heart, lungs, or kidneys. There are two main types of systemic scleroderma: Limited disease (CREST syndrome) and diffuse disease.

Skin symptoms of scleroderma may include:

• Fingers or toes that turn blue or white in response to hot and cold temperatures (See: Raynaud's phenomenon)
• Hair loss
• Skin hardness
• Skin that is abnormally dark or light
• Skin thickening, stiffness, and tightness of fingers, hands, and forearm
• Small white lumps beneath the skin, sometimes oozing a white substance that looks like toothpaste
• Sores (ulcers) on the fingertips or toes
• Tight and mask-like skin on the face

Bone and muscle symptoms may include:

• Joint pain
• Numbness and pain in the feet
• Pain, stiffness, and swelling of fingers and joints
• Wrist pain

Breathing problems may result from scarring in the lungs and can include:

• Dry cough
• Shortness of breath
• Wheezing

Digestive tract problems may include:

• Bloating after meals
• Constipation
• Diarrhea
• Difficulty swallowing
• Esophageal reflux or heartburn
• Problems controlling stools (fecal incontinence)

Signs and tests:

The health care provider will perform a physical exam. The exam may show hard, tight, thick skin.

Your blood pressure will be checked. Scleroderma can cause severe inflammation of small blood vessels, such as those in the kidneys. Problems with your kidneys can lead to high blood pressure.

Blood tests may include:

• Antinuclear antibody (ANA) panel
• Antibody testing
• ESR (sed rate)
• Rheumatoid factor

Other tests may include:

• Chest x-ray
• CT scan of the lungs
• Echocardiogram
• Urinalysis
• Tests to see how well your lungs and gastrointestinal (GI) tract are working
• Skin biopsy