Skin Hardening, but Is It Scleroderma?

Partial hard, stiff skins sometimes emerge on some people. However, apart from deficient intake of vitamin and treatment, this may be an alert of scleroderma symptom, with potential danger lurking, one that we cannot underestimate.

What is scleroderma?

Scleroderma is an autoimmune disease which involves hardening and tightening skin as well as the connective tissues, the fibers that provide the framework and support for our body. This hardening or tightening skin occurs due to damaged small blood vessels and excessive collagen accumulation (connective tissue) within the skin and internal organ.

What are the causes?

Scleroderma is caused by excessive collagen production and accumulation in our body tissues. Collagen is a type of protein that forms connective tissues such as our skin.

The trigger behind this collagen overproduction is not yet known, but it is believed to be closely related to our immune system. For unknown reason, the immune system attacks the body and causes inflammation which then results in collagen overproduction.

Scleroderma classification

There are two types of scleroderma, namely:

1. Systemic scleroderma

Systemic scleroderma affects the skin, tissues under the skin, blood vessels, and internal organs. Systemic scleroderma is divided into two types:

- Limited cutaneous: hardening skin limited to elbow and knee areas, happens to at least 60% of the patients with systemic scleroderma.

- Diffuse cutaneous: extended hardening skin, happens to at least 35% of the patients with systemic scleroderma.

It is important to differentiate both of the types as the width of the affected area determines the number of organs involved.

1. Localized scleroderma

It affects certain part of the skin, forming small thickening skin area (morphea) or a line on the arm, leg, or even temple. This type of scleroderma does not develop into systemic scleroderma and usually occurs to children.

What are the symptoms?

People may experience diverse symptoms of scleroderma, thus the effects vary from mild up to life threatening.

The followings are several clinical symptoms or manifestations of scleroderma:

1. Skin problems - swelling followed by scar tissue formation on the skin, telangiectasia (dilated small blood vessels), calcinosis (calcium deposit within body tissues) Raynaud' s phenomenon (drastically reduced blood flow to fingers or toes marked by color change of fingers and toes).
2. Joint pain.
3. Digestive dysfunction - swallowing difficulty, intestines function impairment.
4. Lungs dysfunction - formation of scar tissue, increased blood flow towards the heart within the arteries inside the lungs (pulmonary hypertension), inflammation.
5. Coronary disorder - heart inflammation, abnormal heartbeat rhythm.
6. Kidney impairment - high blood pressure, kidney failure.

Who is at high risk of developing scleroderma?

Generally, women have a bigger chance of developing scleroderma than men. Women aged 30-50 years of various races and ethnicities are prone to this disease. However, scleroderma may also occur to men and children. Therefore, it is recommended to take a test once there is a symptom.

Scleroderma diagnosis

Diagnosis can be performed based on the patient' s history, physical check-up, and laboratory analysis. This laboratory analysis helps to confirm the suspected autoimmune disease. The analysis to perform for this disease are erythrocyte sedimentation rate (ESR), ANA, and specific antibodies such as: Anti-topoisomerase-1 (anti-scl-70) and anticentromere antibody (ACA) and urinalysis.