Scleroderma mimics

Scleroderma is an uncommon condition, but has features that are commonly encountered in a general population such as Raynaud's phenomenon and gastroesophageal reflux. Therefore having an appropriate level of suspicion for the diagnosis will help facilitate getting them to the appropriate specialist. However, there are other patients who present with features considered to be typical of scleroderma, such as Raynaud's and skin thickening, who may have a syndrome mimicking scleroderma. So familiarity with these mimickers is critical for rheumatologists of other physicians who evaluate patients with scleroderma. Raynaud's phenomenon and digital ischemia can be associated with multiple different etiologies, rheumatic and non-rheumatic and should be considered even in scleroderma patients with atypical findings (i.e., isolated toe ischemia). Skin thickening may have differential of conditions ranging from minor skin irritations (i.e., lichenification from scratching) to a number of systemic diseases that require expertise evaluation (scleroderma, scleromyxedema). This chapter will focus on the differential diagnosis of these two common presentations, Raynaud's phenomenon and skin thickening.