Scleroderma
Scleroderma is a condition in which there are often circulating autoantibodies but the mechanism whereby they induce tissue damage is unclear. This disorder, also called systemic sclerosis, affects tissues throughout the body - but particularly blood vessels and skin. The effect on the blood vessels is that when they are exposed to cold they go into spasm, so the affected part (usually the fingers or toes, sometimes the nose) becomes blue and painful, and may remain so for some time - called Raynaud’s phenomenon. The effect on the skin may be localised or widespread: initially there is oedema as a result of inflammatory stimulation of cells called fibro blasts which produce collagen. The fibres that are laid down cause hardening of the skin (sclerosis means hardening). When this happens in other organs - such as the oesophagus it can interfere with function, causing difficulties with oesophageal motility and problems with swallowing. There is no treatment for scleroderma: where possible the complications that arise can be treated (gastro- oesophageal reflux disease, for example). It may be wise to protect the hands and feet from injuries and the cold, because injuries and poor blood supply do not go well together.
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