Document Detail

Nodular scleroderma: case report and literature review.
MedLine Citation:
PMID:  14677198     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe a unique case of scleroderma (SSc) presenting as multiple keloidal nodules and early-onset osteoarthritis (OA), and to summarize the clinical and serological data for 13 similar patients reported in the English literature since 1966. METHODS: MEDLINE review of the literature over a 35-year period (1966-2002) revealed 13 cases of nodular SSc. We describe a case of nodular SSc in a 40-year-old African-American male with localized SSc who developed progressive skin thickening and keloidal nodules on the arms, hands, chest, abdomen, and thighs with advanced osteoarthritis of the hips. RESULTS: In all 14 cases, diagnosis was made based on skin biopsy and evidence of keloid (nodule) formation. Ten cases occurred in women and 4 in men, with ages ranging from 9 to 66 years and a mean age of 38.9 years. The ethnicity of the patients was given in only 5 of the 13 previously reported cases. Including our patient, 4 were of African descent, and 2 were Caucasian. Most patients had symptoms of SSc consisting of arthralgias (n = 10), sclerodactyly (n = 9), Raynaud's phenomenon (n = 8), digital pitting and/or calcinosis (n = 5), shortness of breath with pulmonary fibrosis (n = 5) or pulmonary hypertension (n = 1), dysphagia or reflux (n = 3), renal disease (n =3), and elevated erythrocyte sedimentation rate (n = 3). CONCLUSION: Nodular SSc is a rare variant that presents with lesions that clinically resemble keloids. OA, as documented in the present case, does not appear to be a typical feature of nodular SSc.
Leander Cannick; Glenn Douglas; Scott Crater; Richard Silver
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  30     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-01-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  2500-2     Citation Subset:  IM    
Department of Internal Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
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MeSH Terms
Hip Joint*
Keloid / etiology*,  pathology
Osteoarthritis / etiology*
Scleroderma, Localized / complications*

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