Scleroderma Types: Localized: Morphea Linear Systemic: Limited cutaneous Diffuse cutaneous Risk Factors: Female sex Age 30-50 Cigarette smoking Autoimmune diseases Environmental factors Pathogenesis: Vascular injury: Endothelial cell damage Microvascular ischemia Immune response: T-helper cells Autoantibodies Fibrosis Fibrosis: Excessive collagen production Organ damage Clinical Features: Skin: Thickening, tightening, and hardening Raynaud's phenomenon Telangiectasias Calcinosis Gastrointestinal: Esophageal dysmotility GERD Malabsorption Pulmonary: Interstitial lung disease Pulmonary hypertension Renal: Scleroderma renal crisis Cardiac: Pericarditis Myocarditis Diagnosis: ANA in almost all patients Anti-topoisomerase I (Scl-70) antibody Anti-centromere antibody Treatment & Management: Usually no cure Symptomatic relief Prevent organ damage Medications: Vasodilators Immunosuppressants ACE inhibitors Calcium channel blockers Proton pump inhibitors Complications: Organ involvement: Esophageal dysmotility Interstitial lung disease Renal crisis Skin changes: Thickening, tightening, and hardening Raynaud's phenomenon Telangiectasias Calcinosis Digital infarcts Joint contractures Malnutrition Prognosis: Varies depending on the type and severity of the disease. Limited cutaneous scleroderma has a better prognosis than diffuse cutaneous scleroderma. Early diagnosis and treatment can improve the prognosis.