The visceral manifestations of scleroderma have been recognized for almost 60 years, but the relative infrequency of the disease and the difficulty of obtaining adequate pathological material have, with certain outstanding exceptions, precluded the pursuit of comprehensive studies. Beerman,1 in an excellent review of the literature, stressed the protean nature of the disease which Becker and Obermayer2 have ably defined as follows:
Generalized scleroderma is not strictly a dermatosis, but rather a disease of the connective tissue of various organs and systems, the skin, subcutaneous tissue, muscles, bones and joints, tendons and fascias, serous surface, internal organs, endocrine glands and nervous system. The patient first notes the surface alterations, consequently the dermatologist is usually first consulted.
Goetz3 has suggested the term "progressive systemic sclerosis" to describe the clinical picture until an etiology has been established. According to the author:
Progressive systemic sclerosis
PIPER WN, HELWIG EB. Progressive Systemic SclerosisVisceral Manifestations in Generalized Scleroderma. AMA Arch Derm. 1955;72(6):535–546. doi:10.1001/archderm.1955.03730360041004
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