Systemic sclerosis / CREST
| Incidental findings | Raynaud’s |
| +ve signs | Tight, shiny skin fingers, sclerodactyly, calcinosis, telangiectasia |
| Differential diagnosis | Systemic sclerosis / CREST |
| Function | Hand function |
| Tests |
FBC, CXR Anticentromere, Anti Scl-70 |
Systemic sclerosis questions
- Do you have any difficulty with swallowing
- Do your fingers change colour in the cold
- Dry eyes/mouth (associated sjogren’s)
Raynauds questions
- Do your fingers change colour in the cold
- What colour do they go – is there a particular sequence (white/blue/red)
- How long have you had this problem
- What is your job; does it involve vibrating tools
Notes
- CREST: Calcinosis, raynauds, esophageal dysmotility, sclerodactyly and telangiectasia. More favourable prognosis than systemic sclerosis; anti-centromere antibody.
- Limited cutaneous scleroderma = only extremities (10y survival 71%), diffuse cutaneous scleroderma = trunk and extremities (10y survival 21%).
- Rx: symptomatic / immunosupression (cyclophosphamide, methotrexate). No role for steroids.