Scleroderma: Or something else? Differential Diagnosis

Chronic cutaneous circumscritical scleroderma

Skin and subcutaneous (L00-L99).

  • Lichen sclerosus et atrophicus – rare, chronic inflammatory progressive connective tissue disease that is probably one of the autoimmune diseases.
  • Pseudoscleroderma (tight skin atrophy (atrophy = decrease) under the image of scleroderma).

Musculoskeletal system and connective tissue (M00-M99).

  • Incipient systemic scleroderma (diffuse cutaneous type).

Systemic scleroderma

Skin and subcutaneous (L00-L99).

  • Pseudoscleroderma (tight skin atrophy (atrophy = decrease) under the picture of scleroderma).
  • Scleromyxedema – mucinous deposition in the skin; localized and systemic fibrosis; frequency associated with gammopathies (see below monoclonal gammopathy).
  • Scleroedema adultorum Buschke – potentially reversible cutaneous-subcutaneous mucinosis (disease associated with increased deposition of glycosaminoglycans in the dermis).
  • Scleredema (doughy edema of the skin with hardening) on the upper body.

Cardiovascular system (I00-I99)

  • Raynaud’s syndrome (Raynaud’s disease) – vascular disease characterized by seizure-like paling of the hands or feet due to vasospasm (vascular spasm).

Musculoskeletal system and connective tissue (M00-M99).

  • Eosinophilic fasciitis (Shulman syndrome) (affects the extremity fascia (fascia = soft tissue components of connective tissue) and subcutis (subcutaneous tissue), not affecting the hands and feet; acute onset, chronic course) with blood eosinophilia.

Psyche – Nervous System (F00-F99; G00-G99).

Injuries, poisonings and certain other consequences of external causes (S00-T98).

  • Nephrogenic systemic fibrosis (NSF; synonyms: Nephrogenic fibrosing dermopathy; dialysis-associated systemic fibrosis); occurs in renal failure patients with an estimated glomerular filtration rate < 30 ml/min/1.73 m2 ; initial symptoms include pain, pruritus (itching) swelling, and erythema ((skin redness); cobblestone-like, hypopigmented plaques (patchy or squamous substance proliferation of the skin); possibly. also fibrosis (proliferation of connective tissue fibers) of the lungs, liver, muscles, diaphragm and heart; poor prognosis, especially with lung involvement; etiology (cause): exposure to gadolinium-containing contrast media.