Typesof scleroderma and typical symptoms

There are two main types of scleroderma:

• localised scleroderma just affects the skin
• systemic sclerosis may affect blood circulation and internal organs as well as the skin

Localised scleroderma

Localised scleroderma is the mildest form of the condition. It often affects children, but can occur at any age.

This typejust affects the skin, causing one or more hard patches to develop. Internalorgans aren't affected.

Exactly how the skin is affected depends on the type of localised scleroderma.There are two types, called morphoea and linear.

Morphoea:

• discolouredoval patches on the skin
• canappear anywhere onthe body
• usually itchy
• patches may be hairless and shiny
• may improve after a few years and treatment may not be needed

Linear:

• thickened skin occurs inlinesalong the face, scalp, legs or arms
• occasionallyaffects underlying bone and muscle
• may improve after a few years, although can cause permanent growth problems, such as shortened limbs

Systemic sclerosis

In systemic sclerosis, internal organscan beaffected as well as the skin. This type mostly affects women and usuallydevelops between30 and 50 years of age. Children are rarely affected.

There are two types of systemic sclerosis, calledlimited cutaneous systemic sclerosis anddiffuse systemic sclerosis.

Limited cutaneous systemic sclerosis:

• a milder form that only affects skin on the hands, lower arms, feet, lower legs and face, although it can eventually affect the lungs and digestive system too
• often starts as Raynaud's phenomenon (a circulation problem where fingers and toes turn white in the cold)
• other typical symptomsinclude thickening of the skin over the hands, feetand face, red spots on the skin,hard lumps under the skin, heartburn andproblems swallowing ( dysphagia )
• tends to get gradually worse over time, although it's generally less severe than diffuse systemic sclerosis and can often be controlled with treatment

Diffuse systemic sclerosis:

• is more likely to affect internal organs
• skin changes can affect the whole body
• other symptoms can include weight loss, fatigue and joint pain and stiffness
• symptoms come on suddenly and get worse quickly over the first few years,butthen thecondition normally settles and the skin may gradually improve

In some cases of systemic sclerosis, organs such as the heart, lungs or kidneys are affected. This can cause a range of potentially serious problems, such as shortness of breath , high blood pressure and pulmonary hypertension (high blood pressure in the lungs).