Scleroderma

Question 1

scleroderma - examination

Answer 1

inspect for sclerodactyly - tight waxy skin, telangiectasia, raynaud’s, tips/knuckles ulceration
palpate - temperature, skin tethering, subcut calcification (extensor aspects)
hand function + prayer sign
check skin on face, upper arms + chest for diffuse cutaneous scleroderma
3-finger test for microstomia

Question 2

scleroderma - history questions

Answer 2

hands change colour in cold? - white, blue, red
get breathless? - scleroderma of chest wall or interstitial fibrosis
get indigestion/heartburn?

Question 3

scleroderma - treatments

Answer 3

raynaud's - nifedipine
skin - methotrexate
GI - PPI
renal crisis - ACEis
pulmonary HTN - sildenafil