Scleroderma11 is recognized as a member of the so-called collagen group of diseases, which includes dermatomyositis, disseminated lupus erythematosus, and periarteritis nodosa. The cutaneous and peripheral vascular manifestations of scleroderma are perhaps more widely appreciated by members of the medical profession than are the other widespread, protean components of this interesting disease. The pathological changes in scleroderma consist of a systemic alteration in the connective tissue framework, and it has been demonstrated that practically every organ in the body may be involved by this disease.3,4,12,19 Since scleroderma is usually a generalized process, Goetz8 has suggested that progressive systemic sclerosis might perhaps serve as a more descriptive terminology.
The disease usually makes its appearance in the fourth or fifth decade of life. The sex incidence is approximately equal, although some feel that there is a slightly higher incidence of the disease in the female. The clinical course of