Scleroderma, as is well known, exists in a circumscribed form (morphea, localized scleroderma, scleroderma en bandes) and as a diffuse type (scleroderma diffusum), in cases of which involvement of the hands (sclerodactylia) may be a prominent feature.
Localized scleroderma is a benign process which may heal spontaneously and which does not lead to any disturbance of the organism as a whole, even when the involvement is of wide extent. Ehrmann and Brünauer,1 who made an exhaustive study of scleroderma, stated that this type may involve a considerable portion of the body though the plaques remain sharply bordered and distinct from one another, a feature to be contrasted to the findings in diffuse scleroderma, in which there are no well marginated plaques.
Diffuse scleroderma is a severe, slowly progressive process which may involve not only the skin but all the connective tissues of the body. As a rule it
BUTLER J, LAYMON CW. NODULAR DIFFUSE SCLERODERMA. Arch Derm Syphilol. 1937;35(5):919–931. doi:10.1001/archderm.1937.01470230157009
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