Abstract

SCLERODERMA: A CASE REPORT

Joice Samuel*

ABSTRACT

Introduction: Scleroderma is a chronic disease of unknown etiology that affects the microvasculature and loose connective tissue. It is characterized clinically by fibrous deposition and obliteration of vessels in the skin, lungs, gastrointestinal tract, kidneys, and heart. Presentation of Case: A 55 year old female patient with scleroderma, interstitial lung disease and pulmonary arterial hypertension with low vitamin D with osteoporosis came with chief complaints of severe burning pain over the right toe, along with pain over the finger tips. She has persistence of breathlessness. Patient has been symptomatic since 1996 (19 years). Her symptoms started as bluish discoloration of the fingers on exposure to cold. She has been on steroid, MMF and tadalafil. On physical examination, patient was found to have salt and pepper pigmentation over bridge of nose, hypopigmented patch over the forehead and generalized skin tightening. Pitting scars over tips of left index and right middle finger. The mouth opening was 2 fingers wide. There was early systolic murmur in pulmonary area. During hospital stay, she was prescribed with antibiotics, glucocorticosteroid, immunosuppressant and analgesics. The patient was discharged with a tapered schedule of steroid, immunosuppressant and analgesics. Conclusion: Pulmonary manifestations of systemic sclerosis include interstitial lung disease, pulmonary hypertension, pleuritis, pleural effusion, and aspiration pneumonia. Physicians and patients with scleroderma should be more attentive to the potential risk factors for organ damage.

Keywords: Scleroderma; Systemic sclerosis.