Scleroderma is difficult to diagnose as it overlaps and resembles many other conditions. Depending on your particular symptoms, a diagnosis of scleroderma may be made by a general internist, a dermatologist (a doctor who specializes in treating diseases of the skin, hair, and nails), an orthopaedist (a doctor who treats bone and joint disorders), a respirologist (a lung specialist), or a rheumatologist (a doctor specializing in treatment of musculoskeletal disorders and rheumatic diseases).
A diagnosis of scleroderma is based largely on a medical history and findings from the physical exam.
Typically, to make a diagnosis, your doctor will ask you about what has happened to you over time and about any symptoms you may be experiencing.
Once your doctor has taken a thorough medical history, he or she will perform a physical exam. Finding one or more of the following factors may indicate scleroderma:
Lastly, your doctor may order lab tests to help confirm a suspected diagnosis. At least two proteins, called antibodies, are commonly found in the blood of people with scleroderma:
A number of other scleroderma-specific antibodies can occur in people with scleroderma, although less frequently. When present, however, they are helpful in clinical diagnosis and may give additional information as to the risks for specific organ problems.
Because not all people with scleroderma have these antibodies and because not all people with the antibodies have scleroderma, lab test results alone cannot confirm the diagnosis.
In some cases, your doctor may order a skin biopsy (the surgical removal of a small sample of skin for microscopic examination) to aid in or help confirm a diagnosis. However, skin biopsies also have their limitations: biopsy results cannot distinguish between localized and systemic disease.
Diagnosing scleroderma is easiest when a person has typical symptoms and rapid skin thickening. In other cases, a diagnosis may take months, or longer, as the disease unfolds and reveals itself and as the doctor is able to rule out some other potential causes of the symptoms. In some cases, a diagnosis is never made, because the symptoms that prompted the visit to the doctor go away on their own.
Some patients have some symptoms related to scleroderma and may fit into one of the following groups:
For more information about medical tests involved initial and ongoing medical monitoring for people with scleroderma, download the Scleroderma Information Pamphlet “Medical Tests” developed by the Scleroderma Society of Canada by clicking here.
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