Scleroderma refers to a group of diseases that happen because the body makes too much of the connective tissue called collagen, a fibrous substance found in the skin, cartilage, tendons, and ligaments; and also in the bones, along with some minerals to add rigidity. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, scleroderma can be localized or systemic, affecting only patches of skin or involving several body systems, including some internal organs. Scleroderma is a progressive disease, with a wide variety and degree of symptoms, meaning its diagnosis may take months, or even years.
Medical History
While localized scleroderma can sometimes receive an early diagnosis, most forms of the disease develop slowly. Because of this, a thorough medical history is in order, so that your doctor can look for a progression of the symptoms, such as Raynaud's syndrome. The Arthritis Foundation states Raynaud's afflicts more than 90 percent of those with scleroderma; frequently, it's the first symptom. In Raynaud's, cold weather or stress leads almost immediately to a change in the color of the fingertips--rapidly turn white, then blue. The doctor might also ask about fatigue, achiness and heartburn.
Physical Exam
Along with the medical history, your doctor will perform a physical exam, looking for a number of different symptoms. Among the most common symptoms: Thickening and hardening of the skin; calcium nodules in or near the joints; changes in the appearance or texture of the skin, such as tightening of the skin around the mouth or swollen fingers; and tiny red spots indicating damage to the small capillaries on the face or in the fingers, the basis of Raynaud's syndrome.
Blood Test
After your doctor establishes that you have the symptoms of scleroderma, you may take a blood test to confirm the condition. The blood test can determine the presence or absence of certain antibodies that are associated with the immune system. Doctors prescribe this test only after a preliminary diagnosis is made, because not everyone with scleroderma has these antibodies and not everyone who has these antibodies has scleroderma.
Biopsy
A doctor may also sometimes order a skin biopsy, meaning he will remove a small section of the affected skin and send it to a lab to have it checked out microscopically for any abnormalities. Unfortunately, unlike the blood test, a skin biopsy won't tell you if the scleroderma is systemic or localized. This test may also aid in ruling out other diseases.
Tests for Accompanying Conditions
Because systemic scleroderma can affect the internal organs, your doctor may also order a pulmonary function test, chest x-ray or other tests to determine if the scleroderma has caused problems in your lungs, gastrointestinal system, kidneys or other organs.
