TY  - CHAP
M1  - Book, Section
TI  - Scleroderma and Morphea
A1  - Mayeaux, Jr., E.J.
A1  - Usatine, Richard P.
A2  - Usatine, Richard P.
A2  - Smith, Mindy A.
A2  - Mayeaux, Jr., E.J.
A2  - Chumley, Heidi S.
PY  - 2019
T2  - The Color Atlas and Synopsis of Family Medicine, 3e
AB  - A  49-year-old  woman  presents  with  skin  changes  on  her  face  and  hands  and  gastroesophageal  reflux  disease.  Examination  of  her  face  shows  multiple  telangiectasias  and  tight  skin  over  her  nose  and  around  her  mouth  (Figure  190-1).  Examination  of  her  hands  shows  tight  skin  over  the  fingers  with  some  deformities  due  to  the  tightening  of  the  skin  (Figure  190-2).  A  closer  look  at  an  individual  finger  shows  pitting  of  the  skin  and  loss  of  the  soft  tissue  of  the  distal  phalanx  (Figure  190-3).  A  "salt-and-pepper"  appearance  is  noted  on  the  forearms  (Figure  190-4)  and  lower  legs.  Some  firm  nodules  around  the  elbows  are  consistent  with  calcinosis.  Her  cardiopulmonary  exam  is  normal.  Further  history  reveals  Raynaud's  phenomenon.  A  diagnosis  of  CREST  syndrome  and  scleroderma  is  made.  The  physician  orders  blood  tests,  chest  X-ray  (CXR),  and  pulmonary  function  tests  (PFTs)  to  determine  if  this  is  limited  cutaneous  systemic  sclerosis  or  diffuse  systemic  sclerosis.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1164362298
ER  -