Wednesday, April 7, 2010

Hard

This patient also has fatigue, stiff joints, weakness, pain, sleeping difficulties, and skin discoloration.

Challenge: What's your diagnosis?

Image shown under Fair Use.

3 comments:

Mike said...

Can't tell if those are sausage and/or pitting fingernails, but I'm going to throw out Psoriatic Arthritis

Maggie said...

Scleroderma?

Craig Chen said...

scleroderma is right! pitting fingernails would definitely be psoriatic arthritis, and i know the picture isn't too good (sorry, couldn't find a great scleroderma picture)
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Hard

In Greek, hard is "scleros." This is scleroderma or systemic sclerosis if associated with internal organ disease. The skin has variable thickening and hardening usually affecting the fingers, hands, and face. Edema, erythema, and induration can also be seen. In systemic sclerosis, extracutaneous involvement can occur in the GI tract, lungs (interstitial lung disease, pulmonary vascular disease), kidneys, and heart.

Sources: UpToDate; hopkinsmedicine.org.