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Diagnosis of Scleroderma
Criteria for Diagnosis of Scleroderma
The American College of Rheumatology classification of scleroderma requires one major or two minor criteria for the diagnosis.
Major Critera - Proximal scleroderma where the skin proximal to the metacarpophalangeal joints in the hand or the metatarsophalangeal joints in the foot is indurated, thickened, and hard and is often shiny with loss of skin surface markings. Loss of skin elasticity also occurs. A "salt and pepper" pattern of hyperpigmentation (excess pigmentation of the skin) and hypopigmentation (reduced pigmentation of the skin) is common.
Minor Criteria
- sclerodactyly - stiffness and tightening of the skin of the fingers
- digital pitted scars or loss of substance of the finger pad
- bibasilar pulmonary fibrosis - fibrosis of the base of both lungs that is evident on a chest X-ray.
The diagnosis of scleroderma is approximately 97% accurate with one major or two minor criteria present.
