| SKIN INVOLVEMENT: MAIN MENU |
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| Sclerodactyly |
| This page was written by Shelley Ensz, and has not yet been medically edited. Scleroderma (SD) affects everyone differently. Just because something is listed here does not mean an individual patient will ever experience it. See Disclaimer. |
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| Overview of Sclerodactyly |
| When the fingers become tight, stretched, wax-like, and hardened it is called sclerodactyly. Sclerodactyly is commonly associated with atrophy of the underlying soft tissues. |
| Photos of Sclerodactyly |
| See Scleroderma Photos. ISN Photo Repository. |
| Sclerodactyly and Scleroderma |
| Systemic scleroderma often affects the hands. The initial stage is swelling (edema), which can last for weeks, months, or years. Often the swelling is intermittent and worse in the morning. It can cause the fingers to look like sausages, with far fewer wrinkles. Skin tightness in the hands can make it impossible to pinch the skin on the fingers. |
| In some people, the fingers eventually begin to harden from fibrosis, and curl inward. They may then become frozen in this clawed position, which is referred to as "sclerodactyly." |
| Sclerodactyly and Other Connective Tissue Diseases |
| The Temporal Relationship of Raynaud's Phenomenon (RP) and Features of Connective Tissue Disease in Rheumatoid Arthritis (RA). Idiopathic RP may have a different clinical effect on RA than secondary RP; the latter is correlated with more severe RA. Sclerodactyly is associated with erosive arthritis and RP in RA. Janet E Pope. J Rheumatol First Release. Oct 1 2008. (Also see: Rheumatoid Arthritis and Raynaud's) |
| Sclerodactyly Treatments |
| It is very important to have treatment and physical therapy starting in the initial stages, before the hands have hardened. Preventing and treating attacks of Raynaud's promptly might lessen the progression of the disease. |
| Therapeutic management of acral manifestations of systemic sclerosis. Acral manifestations of systemic sclerosis include Raynaud's phenomenon, calcinosis cutis, and sclerodactyly. In the later stages of the disease, contractures of the skin and joints as well as obliterative vasculopathy leading to digital ulcers and necrotic lesions may occur. PubMed. Med Klin (Munich). 2007 Mar 15;102(3):209-18. (Also see: Raynaud's, Calcinosis, Digital Ulcers, and Skeletal Involvement: Joint Contractures) |
| Sclerodactyly Treatments: Ineffective |
| Ultraviolet A1 phototherapy for treatment of acrosclerosis in systemic sclerosis: controlled study with half-side comparison analysis. These results suggest that UVA1 phototherapy does not improve cutaneous thickness in acrosclerosis even if few functional improvements, and some ulcerations healings can be occasionally observed. Photodermatology Photoimmunology & Photomedicine, Vol 23, No 6, December 2007, pp. 215-221(7). |
| Sclerodactyly Treatments: Physical and Occupational Therapy |
| Physical therapists can use stretching exercises, warming techniques such as hot wax machines, and form casts to wear (especially at night) so that if the hands do harden, they are molded into the most usable shape for daily activities. |
| Physical and occupational therapists can also help the patient adjust by identifying adaptive devices and lifestyle changes to help counter some of the effects of this disability. |
| For information about physical therapy, along with books, tapes and other resources to deal with sclerodactyly, see Skeletal Involvement: Joints and Muscles by ISN. |
| Autologous stem cell transplantation (ASCT) in diffuse scleroderma: impact on hand structure and function. ASCT improved hand scleroderma over 12 months and resolved previously refractory tenosynovitis. ASCT secondarily improved hand function (paid employment, followed by self-care, home care, then by sport/hobbies). (PubMed) Intern Med J. 2008 Mar 11. (Also see: SCT and Joint Contratures) |
| Improving Hand Function in Childhood Scleroderma using Continuous Passive Motion (CPM). Hand/wrist function in a highly motivated adolescent with localized scleroderma improved with the addition of CPM to her therapeutic regimen. Kimberly A. Wesdock. 1963/662 ACR 2006. (Also see: Juvenile Scleroderma) |
| The Efficacy of Self-Administered Stretching for Finger Joint Motion in Japanese Patients with Systemic Sclerosis. Self-administered stretching program may be useful for improving finger joint motion in patients with SSc. J Rheumatol 2006 August;33:1586–92. (Also see: Muscle and Joint Involvement) |
| Sclerodactyly Treatments: Surgery |
| Surgery of the hand in patients with systemic sclerosis: outcomes and considerations. The goals of surgery for advanced SSc affecting the hand are limited and include pain relief through sympathectomy and increased perfusion, repositioning the digit, providing a functional position of fusion, and modest mobilization through resection arthroplasty. J Rheumatol. 2005 Apr;32(4):642-8. (Also see: Skeletal Involvement, Raynaud's Treatments, and Calcinosis) |
| A five-year followup of hand function and activities of daily living in systemic sclerosis (scleroderma). Regression analysis was done to determine which variables predicted functional ability. Only puffy fingers predicted functional disability. In conclusion, hand impairment persisted over time while functional ability decreased. PubMed. J Hand Ther. 2004 Oct-Dec;17(4):407-11. (Also see: Disability Resources) |
| Evaluation of paraffin bath treatment in patients with systemic sclerosis. In this pilot study hand exercise in combination with paraffin bath seemed to improve mobility, perceived stiffness and skin elasticity. However, further studies with larger sample size are needed to attain more reliable results of the effect of paraffin bath treatment in patients with scleroderma. PubMed. Disabil Rehabil. 2004 Aug 19;26(16):981-7. |
| Sclerodactyly Personal Stories |
| Betty Fults: CREST Scleroderma I would like to talk with someone that has feeding tubes also. Maybe that will help me... |
| Beverly: CREST Scleroderma I was overtired and needed naps in the afternoon, pain was slowly getting the better of me and I finally went to the doctor... |
| Bill: Diffuse Scleroderma I was relieved to have a label for my condition but the doctor was not very reassuring telling me that there was no effective cure or treatment... |
| More Sclerodactyly Personal Stories... |
