Diffuse Systemic Sclerosis (Scleroderma)

 - Pulmonary Fibrosis -> Crackles, Abnormal CXR

 - Pulmonary Hypertension, Right Heart Failure

 - Arrhythmias; Left Heart Failure

 - Esophageal Dysmotility -> esophageal dilation, reflux

 - Gastric Ectasia (Watermelon Stomach)

 - Lower GI Tract dysmotility -> bacterial overgrowth -> diarrhea

 - Malignant HTN -> Renal Failure

 - Mask Facies (i.e. a "purse-string mouth" with decr openinq)

 - Calcinosis cutis (irregular, hard nodules under skin)

 - Sclerodactyly (swollen fingers)

 - Finger/hand/elbow contractures

 - Tendon friction rub

 - Red fingers/toes

 - Raynaud's Phenomenon

   - Decr blood flow into extremities -> White fingers/toes

   - O2 extracted from blood already there -> Blue fingers/toes

 - Peri-ungal capillary loops become dilated, prominent, and bushy

 - Finger pulp atrophy

 - Telangiectasia

 - Digital Ulcerations



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