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Cited by 20Systemic Sclerosis and Related DiseasesEosinophilic Disorders and SyndromesConnective tissue disorders research

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Sclerodermalike syndromes: Great imitators

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Varjú, Cecília, Kumánovics, Gábor, Czirják, László, Matucci-Cerinic, Marco, Minier, Tünde·2020·Clinics in Dermatology
DOI 10.1016/j.clindermatol.2019.10.010
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Abstract

Sclerodermalike syndromes (SLSs) comprise diseases with mucin deposition (eg, scleromyxedema, scleredema), with eosinophilia (eg, eosinophilic fasciitis), metabolic or biochemical abnormalities (eg, nephrogenic systemic fibrosis), or endocrine disorders (eg, POEMS syndrome, or polyneuropathy, organomegaly, endocrinopathy, monoclonal lymphoproliferative disorder, and hypothyroidism). Chronic graft-versus-host disease may also show sclerodermalike skin changes. Inherited progeria syndromes with early aging (eg, Werner syndrome) and a heterogeneous group of hereditary disorders with either skin thickening (eg, stiff skin syndrome) or atrophy and tightening (eg, acrogeria) can also imitate classic systemic sclerosis (SSc). In addition, SLSs can be provoked by several drugs, chemicals, or even physical injury (eg, trauma, vibration stress, radiation). In SLSs, the distribution of skin involvement seems to be atypical compared with SSc. The acral skin involvement is usually missing, and lack of Raynaud phenomenon, scleroderma-specific antinuclear antibodies, the absence of scleroderma capillary pattern, and internal organ manifestations indicate the presence of an SLS. Skin involvement is sometimes nodular, and the underlying tissues can also be affected. For the differential diagnosis, a skin biopsy of the deeper layers including fascia and muscle is required. Histology does not always allow differentiation between SSc and SLSs; therefore, the diagnosis is often based on the distribution, quality of cutaneous involvement, and other accompanying clinical features.

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Cited by

Sorted by citations

Metadata

Authors
Varjú, C., Kumánovics, G., Czirják, L., Matucci-Cerinic, M., & Minier, T.
Affiliations
University of Pecs (HU)
Corresponding author
Minier, Tünde
ORCID
Venue
Clinics in Dermatology
Publisher
Elsevier BV
Published
2020-03
Volume
38
Issue
2
Pages
235-249
ISSN
0738-081X (ISSN-L)
DOI
10.1016/j.clindermatol.2019.10.010
OpenAlex
W2982170050
Cited by
20
References
1
Citations by year
2025: 1 · 2024: 1 · 2023: 6 · 2022: 3 · 2021: 8
FWCI
2.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinics in Dermatology (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Rheumatology › Systemic Sclerosis and Related Diseases
  • Health Sciences › Medicine › Rheumatology › Eosinophilic Disorders and Syndromes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
Keywords
systemic sclerosis, differential diagnosis, scleromyxedema, scleredema, eosinophilic fasciitis, nephrogenic systemic fibrosis, POEMS syndrome, chronic graft-versus-host disease, Hutchinson-Gilford progeria syndrome, Werner syndrome, stiff skin syndrome, drug-induced scleroderma, skin biopsy
MeSH terms
Biopsy, Diagnosis, Differential, Humans, Scleroderma, Systemic, Skin, Syndrome

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