Scleroderma

Scleroderma is a chronic circumscribed affection of the skin, appearing on almost any part of the body, having been observed on the face, neck, upper and lower extremities and elsewhere. It commences with slowly-forming infiltration, apparently permeating the entire thickness of the skin, with slight elevation of the affected area. The color is slightly heightened, with a brownish red tint. At the same time the integument becomes matted to the underlying connective tissue and fasciae, and so tightly bound down to them that no motion of the skin over them is possible, resembling scleriasis in this respect. This condition remains for a varying period, with constant tendency to spread, usually in the form of a band. Thus, when it commences on one of the lower extremities, for instance, it slowly progresses upward, involving a breadth of integument equalling perhaps one-fourth or one-third of the circumference of the limb. After a time the other limb, or one of the arms, may become involved. As the disease progresses, however, the parts first involved undergo a change. The infiltration subsides, and gradually reveals the fact that the normal connective tissue of the skin has in part disappeared. In other words, marked atrophy is manifest. The skin, however, has not loosened its hold on the underlying tissues, and still remains as firmly bound down to them as ever.


The affection is accompanied with very little pain or other local inconvenience, except so far as it interferes with the free action of the joints and muscles.