Swollen fingers could indicate the rare autoimmune disease, scleroderma

Systemic scleroderma, also known simply as scleroderma, is a chronic connective tissue disease characterized by progressive fibrosis of the skin and internal organs. This fibrosis is the result of excessive collagen production, which causes hardening and loss of tissue elasticity.

This disease can manifest in various ways, and its progression varies among patients. In some cases, it progresses slowly and is limited to the skin, while in others, it rapidly attacks internal organs such as the lungs, heart, or kidneys. The exact cause of scleroderma remains unknown, but it is recognized as having an autoimmune basis, with the most likely reason being a genetic defect.

The most characteristic symptom of systemic scleroderma is skin changes, which initially may resemble finger swelling. The skin becomes hard, tight, and shiny, and the fingers have a "sausage-like" appearance. Over time, these changes can spread to other body parts, such as the face, arms, or chest.

In addition to skin changes, systemic scleroderma can cause other symptoms such as joint and muscle pain, breathing problems, gastroesophageal reflux, and Raynaud's phenomenon, characterized by episodic whitening and bluish discoloration of the fingers due to cold or stress. This symptom often appears first in patients and is commonly ignored.

As the disease progresses, the skin on the hands and feet undergoes significant changes, especially around the hands, elbows, feet, and up to the knees. Fingers become swollen, complex, and difficult to move due to contractures and joint restrictions. The skin loses sweat glands and hair follicles, leading to characteristic discolorations called "salt and pepper."

Over time, the skin begins to atrophy, forming hard-to-heal wounds and ulcers. The face also changes; the skin tightens, deep wrinkles are smoothed out, facial expressions are limited, and the nose becomes smaller. Patients often experience muscle, bone, and joint pain. Recurrent arthritis leads to stiffness and restricted mobility. Eventually, swallowing problems, constipation, improper nutrient absorption, and lung disease may develop.

Systemic scleroderma is an incurable disease, but appropriate treatment can slow its progression and alleviate symptoms. Therapy is tailored individually to each patient and may include immunosuppressive drugs, vasodilators, physical therapy, symptomatic treatment, and a special diet.