Scleroderma physical examination

Patients with scleroderma usually appear anxious. Physical examination of patients with scleroderma is usually remarkable for sclerodactyly, Raynaud’s phenomenon, digital ulcers, skin fibrosis, and telangiectasias.

Physical examination of patients with scleroderma is usually remarkable for sclerodactyly, Raynaud’s phenomenon, digital ulcers, skin fibrosis, and telangiectasis.^[1][2][3]

• Patients with scleroderma usually appear anxious

• Vital signs of patients with scleroderma are usually normal
• Hypertension maybe present^[4]

• Skin induration^[5][3]
• Skin fibrosis^[6][7][3]
• Telangiectasias^[1][2][3]
• Calcinosis^[8]

• HEENT examination of patients with scleroderma is usually normal

• Jugular venous distention maybe present suggesting right heart failure due to pulmonary hypertension

• Pulmonary examination of patients with scleroderma is usually normal
• Inspiratory crackles upon auscultation of the lung are suggestive of interstitial lung disease^[9][3]

• Right ventricular heave can be suggestive of pulmonary arterial hypertension (PAH)

• Abdominal distention^[10]

• Back examination of patients with scleroderma is usually normal

• Genitourinary examination of patients with scleroderma is usually normal

• Neuromuscular examination of patients with scleroderma is usually normal

• Myopathy^[5]
• Ulceration of finger tips (ischemic)^[6]
• Contractures of finger flexion
• Raynaud’s phenomenon^[11][3]
• Dilatation of nailfold capillaries^[1][2]
• Sclerodactyly^[1][2]

• 
  Panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [1]
• 
  Necrosis of distal finger in a patient with panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [2]
• 
  Panniculitis and fascitis, streptococcus A septicemia in a patient with Scleroderma who was on high dose steroids
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [3]
• 
  Skin: Scleroderma; shoulders & back
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [4]
• 
  Skin: Scleroderma in crest syndrome; calcinosis at elbow
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [5]
• 
  Hands: Scleroderma
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [6]
• 
  Hand: Scleroderma, finger, posterior nail fold
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [7]
• 
  Skin: Scleroderma, chest, salt and pepper pigmentation
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [8]
• 
  Leg: Morphea, circumscribed scleroderma; age 19
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [9]
• 
  Face: Morphea, circumscribed scleroderma
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [10]
• 
  Clinical appearance of acrosclerotic piece-meal necrosis of the thumb in a patient with systemic sclerosis
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [11]
• 
  Left arm of Scleroderma patient, showing skin lesions
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [12]
• 
  Morphea
  Source:Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology [13]

• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]

• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]

• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]
• 
  Linear scleroderma. Adapted from Dermatology Atlas.^[12]

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