The Differential Diagnosis of Systemic Sclerosis

Alan Tyndall; Susanna Fistarol


Curr Opin Rheumatol. 2013;25(6):692-699. 

In This Article

Diffuse Mimics of Systemic Sclerosis

Many disparate conditions may cause diffuse skin thickening, including inflammatory and immune-mediated disorders (e.g. eosinophilic fasciitis, graft versus host disease[3] and overlap connective tissue diseases (CTDs)), deposition disorders [e.g. scleromyxoedema, scleroedema adultorum, amyloidosis and nephrogenic systemic fibrosis (NSF)], metabolic conditions (e.g. phenylketonuria, porphyria cutanea tarda and hypothyroidism), toxic agents (e.g. silica, polyvinyl chloride, bleomycin and toxic oil syndrome)[4] and genetic diseases (e.g. progeria and Werner's syndrome). Many of these are very rare or obvious from the concurrent clinical picture. The absence of Raynaud's phenomenon, typical nailfold capillaroscopy changes and antinuclear antibodies in a case of suspected SSc should always alert the clinician to an alternative condition.