Scleroderma in the Hand and Its Surgical Approach

摘要

Systemic Sclerosis is a connective tissue disease that involves the skin, GI-tract, kidneys, lung and the heart. Scleroderma, a phenomenon characterized by an involvement of the dermis, can occur in a localized or systemic pattern. The hand is only affected in systemic sclerosis. Although some evidence suggests an immunological origin, the true etiology is still unknown. Mainly the systemic type called systemic sclerosis involves the hand, leading to Raynaud phenomenon, ulcerations, arthropathies and calcifications. Surgical intervention has been controversial due to anticipated wound healing problems arising from diminished blood circulation. Nevertheless a surgical approach is indicated when conservative and pharmacological treatment options fail.1