When Hardening Skin or Reflux Warrants a Scleroderma Evaluation by a Rheumatologist

She noticed it first with her rings. The band that had slid on for a decade now caught at the knuckle, and the skin over her fingers looked oddly glossy, as if polished. A week later the heartburn started, the kind that wakes you at two in the morning. Two complaints, two different doctors, and nobody connecting them.

That gap is exactly where the question of when to see a rheumatologist for scleroderma lives. A rheumatologist is a physician who specializes in autoimmune and connective tissue diseases, and scleroderma sits squarely in that territory. Yet the condition rarely announces itself in one place. It shows up in the hands, then the esophagus, sometimes the lungs, each symptom plausible on its own.

This explainer sets out which combinations deserve a specialist’s eye, what that evaluation actually involves, and how to read the results without panic or false reassurance. The decisions stay with your treating team; the goal here is that you walk in knowing which questions to ask.

When to see a rheumatologist for scleroderma: the combinations that justify a referral

Scleroderma is an autoimmune condition in which the immune system drives excess collagen production, stiffening skin and sometimes internal organs. Because its early features overlap with ordinary complaints, the strongest case for a referral comes from patterns, not single symptoms.

The pattern clinicians weigh most heavily starts with Raynaud’s phenomenon: fingers or toes that blanch white, then turn blue, then flush red in response to cold or stress. Raynaud’s on its own is common and usually harmless. Raynaud’s that arrives in adulthood, affects fingers asymmetrically, or sits alongside puffy, sausage-like fingers that feel tight in the morning is a different matter, and the NHS specifically advises that a GP will refer to a rheumatologist when scleroderma is suspected.

Add any one of the following to that picture and the referral becomes harder to argue against: skin that feels thick or bound down when you try to pinch it, especially on the fingers or face; new or worsening heartburn or difficulty swallowing; small red spots called telangiectasias (dilated surface blood vessels) on the face, lips or palms; sores on the fingertips that are slow to heal; or a positive antinuclear antibody (ANA) test, which is a blood test detecting antibodies directed at the body’s own cell nuclei.

Breathlessness on exertion, dry cough or a new rise in blood pressure change the tempo entirely. Those are signs that internal organs may already be involved, and they should push the conversation from “consider a referral” to “arrange one promptly.” None of this is a diagnosis. It is a threshold, and crossing it simply means the right specialist should be the one looking.

First signs of scleroderma: what is usually the first symptom?

Ask a room of people living with systemic sclerosis what came first and most will describe their hands. Mayo Clinic lists Raynaud’s phenomenon among the earliest signs, and in many people it precedes any visible skin change by a considerable stretch of time. The attacks feel like cold has reached the bone; the fingertips go waxy and numb, and warming them brings a throbbing flush.

The second early sign is often subtler: swelling. Fingers look puffy, rings tighten, and the hands feel stiff on waking in a way that eases but never fully disappears. Clinicians call this the edematous phase, meaning fluid-related swelling that comes before true thickening. Some people describe intense itching over the hands and forearms during this stage, a symptom that is easy to dismiss as dry skin.

Fatigue and aching joints frequently travel alongside these changes. Neither is specific, which is exactly why they rarely trigger a referral on their own. Heartburn, bloating after small meals or food that seems to stick on the way down can also be early, because the smooth muscle of the esophagus is affected in much the same way as skin.

Two caveats matter. First, a minority of people develop internal organ involvement before any skin thickening appears; this is sometimes called systemic sclerosis sine scleroderma, meaning “without skin hardening.” Second, localized scleroderma, also called morphea, produces firm oval patches on the skin without Raynaud’s or internal disease and follows a different path altogether. The first sign, in other words, depends on which form of the condition is present, and only an evaluation can sort that out.

Does a rheumatologist treat scleroderma, and why not start with a dermatologist?

Yes. For systemic sclerosis, the rheumatologist is the physician who usually makes the diagnosis, sets the monitoring plan and coordinates the rest of the team. The reasoning is simple: skin is the visible organ, but the decisions that matter most concern lungs, heart, kidneys and gut, and rheumatology is the specialty trained to weigh all of them in the context of an autoimmune process.

That does not make other specialists irrelevant. Dermatologists are often the right first stop for morphea, the localized form that stays in the skin and rarely involves internal organs. Gastroenterologists investigate swallowing problems and reflux that fail to respond to standard measures. Pulmonologists interpret lung function and chest imaging, cardiologists assess for pulmonary hypertension (high pressure in the arteries of the lungs), and nephrologists step in when kidney involvement is suspected. According to Mayo Clinic, care for scleroderma commonly draws on several of these specialties at once.

Where people get stuck is sequencing. A reasonable path for someone with Raynaud’s and tightening fingers is primary care first, then rheumatology; the rheumatologist decides which other referrals are warranted and in what order. Someone whose only complaint is reflux will usually, and sensibly, see a gastroenterologist first. The gastroenterologist who finds poor esophageal motility with no obvious cause is the one who should start wondering about connective tissue disease.

Patient forums are full of the question “general rheumatologist or scleroderma specialist?” The honest answer is that most people begin with whichever rheumatologist is accessible, and that clinician can involve a center with particular experience if the disease is diffuse, rapidly progressive or involves the lungs. That is a judgment for the treating team, not a hurdle to clear before being seen.

How a scleroderma evaluation actually works, step by step

The first visit is mostly conversation. Expect detailed questions about when Raynaud’s started, how often attacks happen, whether fingers have ever ulcerated, how far up the arms any skin tightness reaches, and what the swallowing and heartburn history looks like. Medication lists matter too, because some drugs can mimic or aggravate Raynaud’s.

Then comes the examination, and it is tactile. The clinician pinches skin at standardized sites, from fingers to upper arms to chest, grading how easily a fold lifts. Skin that will not lift, or lifts only as a thick slab, scores as thickened. This is the modified Rodnan skin score, a bedside method for tracking skin involvement over time. The face, mouth opening, fingertips and nail beds are inspected for telangiectasias, pitting scars and ulcers.

Nailfold capillaroscopy follows in many clinics: a magnifying lens or microscope is placed over the base of the nail to look at the tiny blood vessels there. In primary Raynaud’s they look orderly; in scleroderma they are often enlarged, dropped out or hemorrhaged. It is painless and takes minutes.

Blood work typically includes an ANA and, when positive, more specific antibodies: anti-centromere, anti-Scl-70 (also called anti-topoisomerase I) and anti-RNA polymerase III. Kidney function, urinalysis and a blood pressure reading are standard because kidney involvement can be silent.

Finally, baseline organ screening. Mayo Clinic describes pulmonary function tests (breathing into a machine to measure lung capacity and gas transfer), an echocardiogram (ultrasound of the heart) and, when indicated, a high-resolution CT scan of the chest. These are ordered even when you feel well, because the point of a baseline is to catch change early rather than to confirm something already obvious.

How do you rule out scleroderma? What a negative test can and cannot tell you

Ruling scleroderma in is often easier than ruling it out, and patients deserve to hear that plainly. There is no single test that closes the question. Instead, clinicians combine three sources of evidence: the examination, the antibody profile and the capillaroscopy, interpreted together over time.

A negative ANA lowers the likelihood considerably, because the large majority of people with systemic sclerosis test positive, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. It does not reduce the likelihood to zero. Conversely, a positive ANA on its own is weak evidence; it turns up in other autoimmune conditions and in healthy people, which is why the more specific antibodies matter. Anti-centromere antibodies point toward limited disease; anti-Scl-70 toward diffuse disease with higher lung risk; anti-RNA polymerase III toward rapid skin progression and kidney risk. Having none of these does not exclude the diagnosis, but it shifts the odds.

Normal nailfold capillaries in someone with Raynaud’s are genuinely reassuring. Abnormal capillaries with Raynaud’s, even before skin change, are among the earliest objective clues and usually earn closer follow-up rather than discharge.

Classification criteria used in research, which assign points for skin thickening, fingertip lesions, telangiectasias, abnormal capillaries, pulmonary involvement, Raynaud’s and specific antibodies, help standardize who counts as having the disease in studies. They are not a diagnostic checklist for individuals, and an experienced rheumatologist may diagnose, or decline to diagnose, outside them.

The practical upshot: if you have Raynaud’s, a negative ANA and normal capillaries, most clinicians will label it primary Raynaud’s and ask you to return only if new features appear. If any one of those three is abnormal, expect a scheduled review rather than a clean bill.

Limited vs diffuse systemic sclerosis: a table of what changes the urgency

Systemic sclerosis is usually divided into two subtypes, and the division is not academic. It shapes how fast the disease tends to move, which organs the team watches most closely and how quickly a referral should happen. Limited cutaneous disease was previously called CREST syndrome, an acronym for its typical features: Calcinosis (calcium deposits under the skin), Raynaud’s, Esophageal dysmotility, Sclerodactyly (tight skin of the fingers) and Telangiectasia.

Feature	Limited cutaneous (formerly CREST)	Diffuse cutaneous
Skin involvement	Fingers, hands, forearms below the elbow, lower legs, face	Extends above elbows and knees, often trunk
Raynaud’s timing	Often present for years before other features	Often begins close to the onset of skin change
Typical antibody	Anti-centromere	Anti-Scl-70 or anti-RNA polymerase III
Main internal concerns	Pulmonary hypertension, esophageal disease, later-onset gut problems	Interstitial lung disease, kidney crisis, heart involvement
Usual pace	Slow, over many years	Can progress over months
Referral tempo	Routine specialist review	Prompt specialist review

Two cautions keep this table honest. “Limited” describes the skin, not the stakes; pulmonary hypertension in limited disease is serious and is one reason annual heart screening is standard, as Johns Hopkins Medicine notes. And the subtypes are not sealed categories. Some people sit between them, and a small group develop internal disease with little or no skin change.

For someone deciding whether to push for a referral, the practical reading is this: skin tightness creeping above the elbows or onto the chest, particularly if it has happened within a short span, is a reason to be seen soon rather than at the next routine slot.

Who is usually referred quickly, and who is usually asked to watch and wait

Rheumatology triage is pragmatic. Clinicians sort referrals by the likelihood of early organ damage, and understanding that logic helps patients know where they stand.

Those typically seen quickly share certain features. Skin thickening that has spread beyond the hands within a short period. Raynaud’s that has produced fingertip ulcers or pitted scars. A new rise in blood pressure, headaches or visual disturbance in someone with recent skin change, because these can herald scleroderma renal crisis, a sudden kidney emergency. Breathlessness on climbing stairs, a dry cough that lingers, or swelling of the ankles. A positive anti-Scl-70 or anti-RNA polymerase III antibody, which flags a higher-risk subtype. Mayo Clinic notes that scleroderma affects women more often than men and most commonly begins between the ages of 30 and 50, but age and sex do not change triage; features do.

Those more often asked to watch and wait look different. Long-standing Raynaud’s that began in the teens, affects all fingers symmetrically and has never caused a sore. A negative ANA with normal nailfold capillaries. Isolated heartburn with no hand or skin findings, which usually belongs with gastroenterology first. A single firm patch of morphea without Raynaud’s, which dermatology typically manages. Waiting here does not mean dismissal; it means a plan for what would prompt a return.

The group that most needs an advocate sits between these. Think of the person with new adult-onset Raynaud’s and mildly puffy fingers but normal bloods, told it is “probably nothing.” Probably is usually right. A documented examination and a clear instruction to return if skin tightens, swallowing changes or breathlessness appears turns that “probably” into a safety net rather than a dead end.

Scleroderma acid reflux: why heartburn matters more than it sounds

Heartburn is so ordinary that it rarely frightens anyone. In scleroderma it deserves more respect, and the reason is mechanical. The lower two-thirds of the esophagus is lined with smooth muscle, the same tissue type the disease stiffens in blood vessels and gut. When that muscle weakens and scars, two things happen: the ring of muscle at the bottom of the esophagus no longer closes properly, and the coordinated waves that push food downward lose their strength. Acid flows up freely and is cleared slowly.

The result is reflux that tends to be persistent, often worse lying down, and sometimes present without classic burning. People describe food sticking behind the breastbone, a hoarse voice in the mornings, chronic throat clearing or a cough that no inhaler touches. MedlinePlus lists swallowing difficulty and reflux among the common digestive features of the condition.

Why does a rheumatologist care about a stomach problem? Partly because chronic acid exposure can inflame and narrow the esophagus. Partly because refluxed material reaching the airways is suspected of aggravating lung inflammation in people who already have interstitial lung disease, which makes reflux control a lung-protection strategy as much as a comfort measure. And partly because gut involvement rarely stops at the esophagus; bloating, early fullness and alternating bowel habit can follow as the stomach and small intestine slow down.

Evaluation may involve an endoscopy (a camera passed down the throat) or a manometry study that measures pressure along the esophagus. Treatment usually begins with the proton pump inhibitor class, medicines that reduce stomach acid production, together with practical measures like raising the head of the bed. Which option, and for how long, is a decision for the prescribing clinician who knows your full picture.

What the weeks after a referral usually look like

The period between referral and a settled plan can feel oddly quiet, and knowing the sequence makes the silence easier to tolerate.

The first consultation does the heavy lifting described earlier: history, skin scoring, capillaroscopy, blood pressure, and a set of blood tests sent off that day. Routine results such as kidney function return quickly. Specific antibodies are often processed by specialized laboratories and can take longer, so a gap before the results discussion is normal rather than ominous.

In parallel, baseline organ tests are scheduled. Pulmonary function testing and an echocardiogram are frequently booked in the same stretch, and a chest CT is added if the breathing tests, the examination or the antibody pattern raise concern. Few of these happen on the same day as the first visit; most people make several separate trips.

The second visit pulls the threads together. One of three conversations usually follows. The first: features and tests fit systemic sclerosis, a subtype is assigned, and a monitoring plan is set with intervals for repeat lung and heart screening. The second: findings are suggestive but incomplete, and the clinician asks for a scheduled review to see whether the picture evolves. The third: the evaluation points away from scleroderma, often toward primary Raynaud’s or another condition, with clear instructions on what would warrant coming back.

Between visits, people are commonly asked to check blood pressure at home, especially with diffuse disease, and to photograph any finger sores. Johns Hopkins Medicine emphasizes that ongoing monitoring is a core part of care precisely because the disease can change course. How often that monitoring happens is set by the treating team and adjusted to your subtype and findings.

What treatment can and cannot do, explained by medicine class

Nobody should leave a rheumatology appointment expecting a single medicine to switch the disease off. There is no therapy that reliably reverses established fibrosis, and honest clinicians say so. What treatment does well is target individual problems and, in some situations, slow progression. Everything below is descriptive; which option suits a given person is a decision for the prescribing clinician.

For Raynaud’s and poor finger circulation, the mainstay is the calcium channel blocker class, medicines that relax the muscle in artery walls so vessels stay wider in the cold. When ulcers develop or fail to heal, clinicians may consider other vasodilator classes, including phosphodiesterase-5 inhibitors and prostacyclin analogues, which open vessels through different pathways.

For skin thickening that is spreading and for interstitial lung disease, the approach is immunosuppression: medicines that dampen the immune activity driving collagen production. Mayo Clinic describes immunosuppressant use for these indications. Effects are judged over months through repeat skin scores and lung function, not over weeks, and the aim is stabilization rather than restoration.

For reflux, acid-suppressing medicines are standard, as discussed above. For pulmonary hypertension, dedicated therapies that lower pressure in lung arteries exist and are started by specialist teams after confirmatory testing. For scleroderma renal crisis, the angiotensin-converting enzyme inhibitor class is the established cornerstone and is why rapid recognition of rising blood pressure matters so much.

Alongside medicines, hand therapy to preserve finger movement, skin care, keeping warm, and stopping smoking all have a place, and the last of these is the single lifestyle change with the clearest vascular rationale. Antifibrotic medicines developed for other lung diseases are now used in some patients with scleroderma-related lung involvement; evidence supports slowing lung decline rather than repairing it.

What triggers a scleroderma flare-up? What the evidence actually shows

The word “flare” is borrowed from conditions like lupus, where disease activity visibly waxes and wanes. In systemic sclerosis the concept is less well defined, and that honesty matters, because people often blame themselves for symptom spikes that reflect the slow underlying process rather than anything they did.

Some triggers are well established. Cold is the most consistent, and it acts directly on the vessels: lower temperatures provoke Raynaud’s attacks, and repeated attacks raise the risk of fingertip injury. Emotional stress triggers the same vessel narrowing through the nervous system; Mayo Clinic lists both cold and stress as triggers for Raynaud’s episodes. Smoking constricts small arteries and damages their lining, and the NHS advises people with scleroderma not to smoke for this reason. Vibrating tools and certain medicines that narrow blood vessels, including some decongestants and migraine treatments, can also worsen attacks, which is one reason the medication list gets scrutinized.

For reflux, large late meals, lying flat after eating, alcohol and tight clothing around the waist are the familiar culprits, and they apply with extra force when esophageal muscle is already weak.

Beyond these, the evidence thins out. Infections appear to precede worsening in some people, and the biological logic is plausible, but the data are observational and cannot prove cause. Claims that specific foods, weather fronts or hormonal cycles drive skin progression are largely anecdotal. There is no diet shown to alter the course of fibrosis.

The useful response is a symptom diary rather than a list of forbidden things. Patterns that repeat for you are worth sharing with your team; patterns that appear once are usually coincidence.

What people often get wrong about when to see a rheumatologist for scleroderma

Misconceptions about this condition tend to delay care in one direction or inflate anxiety in the other. A few are worth dismantling.

“You need hard skin before anyone will take it seriously.” Skin thickening is often a later feature. Raynaud’s with abnormal nailfold capillaries or a scleroderma-specific antibody is enough to warrant specialist follow-up, well before any skin is tight.

“A positive ANA means I have scleroderma.” It does not. ANA positivity is common and nonspecific; it is the start of a workup, not the end. Equally, a negative ANA makes the diagnosis less likely but does not close the door.

“Only middle-aged women get it.” Women are affected more often and onset peaks between 30 and 50 according to Mayo Clinic, but men and younger people are diagnosed too, and men with diffuse disease are not a group to overlook.

“Patches of hard skin on my body mean systemic disease.” Localized scleroderma, or morphea, produces firm patches and rarely affects internal organs. The two share a name and little else.

“Mild symptoms mean mild disease.” Lung and kidney involvement can be silent in early stages. Baseline screening exists precisely because how you feel is an unreliable gauge of what is happening inside.

“Reflux is a separate problem.” In someone with Raynaud’s and puffy fingers, new heartburn is part of the same picture and belongs in the same appointment.

“Seeing a rheumatologist commits me to strong medicines.” An evaluation is information. Many people leave with a monitoring plan and nothing more, and every treatment decision remains a shared one with the clinician who prescribes.

Questions to ask your care team

A rheumatology consultation covers a great deal of ground, and the questions below are meant to be taken in rather than fired off in sequence. Pick the ones that match where you are.

• Based on today’s examination, do my findings point toward primary Raynaud’s, limited systemic sclerosis, diffuse systemic sclerosis or something else entirely?
• Which antibodies are you testing for, and what would each result change about my follow-up?
• Did my nailfold capillaries look normal, and if not, what did you see?
• Which baseline organ tests are you ordering, and how will I receive the results?
• Should I monitor my blood pressure at home, and what reading should prompt a same-day call?
• How will you measure whether my skin is changing between visits?
• Is my reflux likely connected to this condition, and should a gastroenterologist be involved?
• How often will my lungs and heart be rechecked, and what symptoms should bring me in sooner?
• If treatment is suggested, what specifically is it aiming to do: ease a symptom, protect an organ or slow progression?
• What is the plan if the picture is unclear today, and when would you want to see me again?
• Are there medicines I currently take that could worsen Raynaud’s or reflux?
• Which members of the wider team, such as hand therapy or respiratory specialists, might become involved and when?

Bring a written list of your current medicines, photographs of any finger sores or skin changes, and a rough timeline of when each symptom started. Clinicians make better decisions with a clear history, and you will remember more if you leave with notes rather than relying on recall in the car park.

When to call your doctor: red flags that should not wait

Most of scleroderma is a slow story, but a handful of developments are urgent, and recognizing them is the one piece of self-monitoring every patient should be taught.

Seek emergency care the same day for a sudden, marked rise in blood pressure, particularly with a severe headache, blurred vision, confusion or breathlessness. These can signal scleroderma renal crisis, a rapid kidney emergency that Johns Hopkins Medicine describes as most likely early in diffuse disease. Kidney damage can occur quickly, and prompt treatment with the right medicine class changes the outcome. Chest pain, fainting or sudden shortness of breath at rest also belong in an emergency department.

Call your rheumatology team promptly, within days rather than at the next routine visit, for: a fingertip sore that is enlarging, blackening or showing signs of infection such as spreading redness or pus; new breathlessness on exertion or a dry cough that persists; food repeatedly sticking or an inability to swallow liquids; vomiting blood or passing black stools, which can indicate bleeding from an inflamed esophagus; new swelling of the ankles; or skin tightness that has visibly spread over a short period.

Fever while taking immunosuppressant medicines deserves a call rather than a wait-and-see approach, because those medicines blunt the body’s ability to fight infection.

For symptoms that are new but not alarming, such as increasing stiffness or more frequent Raynaud’s attacks, note the dates and raise them at your next scheduled appointment, or ask for an earlier one if they worsen. Clinicians would rather hear about a change that turns out to be minor than learn afterward that a warning sign was weathered at home. The threshold for calling is lower than most people assume, and your team will tell you if it needs adjusting.

Frequently asked questions

How is scleroderma diagnosed?

Scleroderma is diagnosed through a combination of examination, blood tests and organ screening rather than a single test. A rheumatologist assesses skin thickness, inspects nailfold capillaries, orders antinuclear and scleroderma-specific antibodies, and arranges baseline lung function tests and an echocardiogram. Findings are weighed together, sometimes over more than one visit, before a diagnosis is confirmed or set aside.

What is usually the first symptom of scleroderma?

Raynaud’s phenomenon is usually the first symptom: fingers or toes turning white, then blue, then red in cold or stress. Puffy, stiff fingers and itching often follow. Mayo Clinic lists Raynaud’s among the earliest signs, and in limited disease it can precede skin changes by years. A minority develop internal involvement before any skin hardening appears.

Does a rheumatologist treat scleroderma?

Yes. Rheumatologists diagnose systemic sclerosis, set the monitoring plan and coordinate other specialists. Because the condition can affect lungs, heart, kidneys and gut, pulmonologists, cardiologists, gastroenterologists and nephrologists often join the team. Localized scleroderma, or morphea, which stays in the skin, is usually managed by dermatologists instead.

How do you rule out scleroderma?

Scleroderma is ruled out by combining a normal skin examination, a negative antinuclear antibody test and normal nailfold capillaries, ideally reviewed over time. No single result excludes it completely. If all three are reassuring in someone with Raynaud’s, clinicians usually diagnose primary Raynaud’s and ask them to return only if skin tightness, swallowing problems or breathlessness develop.

What triggers a scleroderma flare-up?

Cold, emotional stress, smoking and certain vessel-narrowing medicines are the best-established triggers for Raynaud’s attacks in scleroderma. Late large meals and lying flat worsen reflux. Evidence that infections or specific foods drive skin or organ progression is observational and weak. A symptom diary shared with your team is more useful than avoiding unproven triggers.

Can scleroderma cause acid reflux without visible skin changes?

Yes. Esophageal muscle can weaken before, or without, noticeable skin thickening, producing persistent reflux, food sticking or hoarseness. This is one reason unexplained poor esophageal motility found during gastroenterology testing should prompt consideration of connective tissue disease, especially when Raynaud’s or puffy fingers are also present. Systemic sclerosis without skin hardening is recognized, though uncommon.

Is a positive ANA enough to diagnose scleroderma?

No. A positive antinuclear antibody test is common across many autoimmune conditions and occurs in some healthy people. It is a reason to test for more specific antibodies, such as anti-centromere, anti-Scl-70 and anti-RNA polymerase III, and to examine the skin and nailfold capillaries. Diagnosis rests on the whole picture, not on one blood result.

What is the difference between morphea and systemic sclerosis?

Morphea, or localized scleroderma, causes firm, discolored patches of skin and rarely involves internal organs or Raynaud’s; dermatologists usually manage it. Systemic sclerosis affects blood vessels and can involve the esophagus, lungs, heart and kidneys alongside skin; rheumatologists lead its care. Sharing a name does not mean sharing a prognosis or a treatment plan.

Should I see a general rheumatologist or a scleroderma specialist first?

Most people begin with whichever rheumatologist is accessible through their primary care referral, and that clinician decides whether input from a center with particular scleroderma experience is warranted. Diffuse, rapidly progressive disease or lung involvement are typical reasons for that step. Waiting for a specialist before being seen at all is rarely sensible.

How often will I be monitored after a scleroderma evaluation?

Monitoring intervals are set by your treating team and depend on subtype, antibodies and baseline findings. Johns Hopkins Medicine describes regular lung and heart screening as a core part of care because the disease can change course. People with diffuse disease are often asked to check blood pressure at home, while those with stable limited disease are typically reviewed less intensively.

References

• NHS: Scleroderma
• MedlinePlus: Scleroderma
• NIH NIAMS: Scleroderma

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.