RT Book, Section A1 Hummers, Laura K. A1 Wigley, Fredrick M. A2 Imboden, John B. A2 Hellmann, David B. A2 Stone, John H. SR Print(0) ID 57272580 T1 Chapter 25. Scleroderma T2 CURRENT Diagnosis & Treatment: Rheumatology, 3e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-163805-0 LK accessmedicine.mhmedical.com/content.aspx?aid=57272580 RD 2023/02/08 AB The most frequent symptoms are (in descending order) Raynaud phenomenon, gastroesophageal reflux with or without dysmotility, skin changes, swollen fingers, and arthralgias.Patients with Raynaud phenomenon and features atypical for primary Raynaud phenomenon should be evaluated for the possibility of scleroderma or another connective tissue disease.A negative antinuclear antibody test (by indirect immunofluorescence) makes the diagnosis of scleroderma very unlikely.The degree of skin involvement is highly variable. Many patients with limited scleroderma have only subtle cutaneous findings (eg, mild sclerodactyly).The current classification criteria do not include many patients with milder forms of scleroderma.Some patients may have overlapping clinical features with other systemic autoimmune rheumatic disorders such as polymyositis/dermatomyositis, Sjögren syndrome, systemic lupus erythematosus, and rheumatoid arthritis.