Systemic sclerosis (SSc) is a connective tissue disease of unknown etiology. Fibrotic changes of the skin, subcutaneous tissue, and viscera; abnormalities of the microvasculature; and immune dysfunction characterize this disorder. In one of the first references to SSc in the medical literature, Addison referred to the skin changes as "keloid" in nature.

  1. Raynaud phenomenon is usually the first symptom of systemic sclerosis.
  2. Patients experience episodes of vasospasm , which causes blood vessels in the fingers and toes to constrict.
  3. As less blood is reaching these extremities the skin changes colour to white and the fingers and toes may feel cold and numb.
  4. As they warm up, they go blue and then red before returning to normal again.