Localized scleroderma and systemic sclerosis or systemic scleroderma are the two major types of sclerodermas. Scleroderma involves the hardening and tightening of the skin. It may also cause problems in blood vessels, internal organs, and the digestive tract.
The key difference between localized scleroderma and systemic sclerosis is the organs they affect. Localized scleroderma only affects the skin, while systemic sclerosis affects both the skin and the internal organs in the body.
CONTENTS
1. Overview and Key Difference
2. What is Localized Scleroderma
3. What is Systemic Sclerosis
4. Similarities – Localized Scleroderma and Systemic Sclerosis
5. Localized Scleroderma vs Systemic Sclerosis in Tabular Form
6. Summary – Localized Scleroderma vs Systemic Sclerosis
7. FAQ – Localized Scleroderma and Systemic Sclerosis
What is Localized Scleroderma?
Localized scleroderma is a type of scleroderma that only affects the skin and the structures directly under the skin. It generally affects the skin and underlying connective tissues such as subcutaneous tissue, fascia, muscle, or bone. Localized scleroderma causes cutaneous patches or bands of skin inflammation and thickening, affecting areas such as the head, neck region, trunk, and extremities.
Figure 01: Localized Scleroderma
The symptoms of this condition may include areas of the skin that may be thickened and discolored gradually and hair loss that may occur over the affected area. The exact cause of this condition is not clear. However, it is believed to be caused by too much collagen produced by fibroblast cells. The collagen gets deposited in the skin, causing scarring and thickening. Fibroblasts produce too much collagen in the areas of the affected skin, probably due to a fault in the immune system.
Localized scleroderma can usually be recognized by its physical appearance. The other tests that may be used for confirmation are biopsy, blood tests, MRI, ultrasound, and X-ray. Furthermore, treatment options for localized scleroderma may include phototherapy and taking systemic immunosuppressants.
What is Systemic Sclerosis?
Systemic sclerosis is an autoimmune rheumatic disease. It is characterized by excessive production and accumulation of collagen (fibrosis) in the skin and internal organs and injuries to small arteries. The symptoms of this condition may include hardening and tightening of the skin, swelling followed by thickening and tightening of the skin at the fingertips, skin becoming more taut, shiny, and darker than usual, a grating sound that can be felt or heard particularly at the knees, elbows, and wrists, as well as heartburn, difficulty swallowing, bloating, diarrhea, constipation, fecal incontinence, shortness of breath, decreased exercise tolerance, and dizziness.
Figure 02: Systemic Sclerosis
Systemic sclerosis can be diagnosed through physical examination, blood tests, imaging tests, and organ function tests. Furthermore, treatment options for systemic sclerosis may include medicines such as blood pressure medicines, immunosuppressants, pills to reduce stomach acid, antibiotics, pain-relieving medications, physical or occupational therapy, and surgical and other procedures like stem cell transplants.
Similarities Between Localized Scleroderma and Systemic Sclerosis
- Localized scleroderma and systemic sclerosis are two main types of scleroderma.
- Both types are believed to be caused by autoimmune reactions.
- Both types are characterized by hardening and thickening of the skin in various areas of the body.
- They can be diagnosed through physical examination, blood tests, and imaging tests.
- They can be treated through specific medications and therapies.
Difference Between Localized Scleroderma and Systemic Sclerosis
Definition
- Localized scleroderma is a type of scleroderma that only affects the skin and the structures directly under the skin, such as subcutaneous tissue, fascia, muscle, or bone.
- Systemic sclerosis is a type of scleroderma that affects numerous organ systems in addition to the skin.
Commonness
- Localized scleroderma is a more common type.
- Systemic sclerosis is a less common type.
Signs and Symptoms
- Localized scleroderma is characterized by isolated patches of hardened skin on the face, hands, and feet or anywhere else on the body, usually with no internal organ involvement.
- Systemic sclerosis is characterized by skin thickening of the fingers and toes, abnormal nail fold capillaries, internal organ fibrosis, or vascular damage involving the lungs, heart, gastrointestinal tract, and/or kidneys.
Diagnosis
- Localized scleroderma can be diagnosed through physical examination, biopsy, blood tests, MRI, ultrasound, and X-ray.
- Systemic sclerosis can be diagnosed through physical examination, blood test, skin biopsy, trichoscopy, pulmonary function test, high-resolution CT scan, echocardiogram, right heart catheter test, ECG, cardiac MRI, Barium swallow, manometry, and endoscopy.
Treatment
- Localized scleroderma can be treated through phototherapy and taking systemic immunosuppressants.
- Systemic sclerosis can be treated through specific medications like corticosteroids, immunosuppressants, nonsteroidal anti-inflammatory drugs (NSAIDs), blood pressure medication, medication to aid breathing, nitroglycerine 2 percent ointment, calcium channel blockers, like Nifedipin, physical or occupational therapy, regular dental care to prevent damage to the mouth and teeth, surgical and other procedures like stem cell transplants.
The following table summarizes the difference between localized scleroderma and systemic sclerosis.
Summary – Localized Scleroderma vs Systemic Sclerosis
Scleroderma is an autoimmune condition that causes inflammation and fibrosis in the skin and other areas of the body. Localized scleroderma and systemic sclerosis are two main types of scleroderma. Localized scleroderma is a type of scleroderma that only affects the skin and the structures directly under the skin, while systemic sclerosis is a type of scleroderma that affects both the skin as well as the internal organs such as blood vessels, muscles, heart, digestive system, lungs and kidneys in the body. This is the basic difference between localized scleroderma and systemic sclerosis.
FAQ: Localized Scleroderma and Systemic Sclerosis
1. What is the prognosis for localized scleroderma?
- The prognosis for localized scleroderma is generally favorable within 5 years. Localized scleroderma is not usually life-threatening but can severely affect the quality of life, particularly in children.
2. How to treat localized scleroderma?
- Localized scleroderma is treated with initial therapies such as phototherapy. Systemic treatments may include immunosuppressants like methotrexate, systemic glucocorticoids, and mycophenolate
3. What are the symptoms of systemic sclerosis?
- The symptoms of systemic sclerosis include Raynaud syndrome, polyarthralgia, dysphagia, heartburn, swelling and eventually skin tightening and contractures of the fingers, bloating, diarrhea, constipation, fecal incontinence, shortness of breath, decreased exercise tolerance, and dizziness.
4. What is the early detection of systemic sclerosis?
- The early detection of systemic sclerosis is done by physical appearances such as Raynaud’s phenomenon, puffy fingers, blood tests for disease-specific autoantibodies, and microvascular alterations at capillaroscopy.
5. Is systemic sclerosis treatable?
- There is no proper cure for systemic sclerosis. However, the symptoms of systemic sclerosis can be controlled by medications like nonsteroidal anti-inflammatory drugs (NSAIDs), immunosuppressants, blood pressure medications, medication to aid breathing, nitroglycerine 2 percent ointment, calcium channel blockers, physical or occupational therapy, surgical and other procedures like stem cell transplants.
Reference:
1. “Localised Scleroderma.” SRUK.
2. Herndon, Jaime. “Systemic Sclerosis (Scleroderma): Pictures, Symptoms, Causes.” Healthline, Healthline Media.
Image Courtesy:
1. “Localised scleroderma of the face Wellcome L0061964” By Welcome Image Gallery (CC BY 4.0) via Commons Wikimedia
2. “Systemic sclerosis, changes on hands are allways bilateral” By Maria Sieglinda von Nudeldorf – Own work (CC BY-SA 4.0) via Commons Wikimedia
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