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1. What is scleroderma?

   Scleroderma, which literally means "hard skin," is caused by an overproduction of collagen in your body's connective tissue. Collagen is normally responsible for keeping your skin and organs supple, but when it is overproduced, it makes tissue thick and immobile.

2. What's the difference between localized scleroderma and systemic sclerosis?

   Localized scleroderma is the milder version, and the skin is generally the only organ affected. In one manifestation, called morphea, oval patches of inflamed and discolored skin may appear on the body. Systemic sclerosis may affect connective tissue in various parts of your body, such as skin, the esophagus, gastrointestinal tract, lungs, kidneys, heart and other internal organs. It can also affect blood vessels, muscles and joints. This form of scleroderma can lead to disfigurement, serious disability, organ failure and early death.

3. Do breast implants cause scleroderma?

   There is no evidence that breast implants cause scleroderma.

4. What causes scleroderma?

   Some people are born with a heightened genetic susceptibility, but other factors, including environmental ones, appear to play a part in development of the disease. Since women are four times more likely to contract scleroderma, gender obviously has a role. Scleroderma in men sometimes can be traced to particular environmental triggers: for example, exposure to silica dust. Exposure to solvent mixtures used in paint thinners and removers has been reported to increase the risk of scleroderma in women.

5. Is there a proven cure for scleroderma?

   No, although the disease may spontaneously improve as various treatments are being used. Symptoms often can be managed through lifestyle modifications and medications. Symptoms vary so widely from one individual to another, however, that treatment guidelines cannot be standardized. If you have scleroderma, talk to your health care professionals about the best ways to treat your symptoms.

6. How can I tell if I have scleroderma?

   Diagnosis is complicated, and you may need to consult more than one health care professional, for example a rheumatologist and dermatologist. Symptoms may include such nonspecific manifestations as extreme fatigue and pain in the joints, bones and muscles. Some of the more particular hallmarks of scleroderma include thickening or hardening of the skin; finger ulcerations (sores); Raynaud's phenomenon (abnormal sensitivity to cold and change in color in the extremities); digestive symptoms and gastrointestinal tract problems; shortness of breath; palpitations; and dry mucus membranes. A diagnosis will take into account presence of one or more of these symptoms, as well as blood tests for autoantibodies and perhaps a nailfold capillary test.

7. How can I prevent scleroderma?

   There is no known way to prevent scleroderma.

8. Can I have a baby if I have scleroderma?

   If you have been diagnosed with scleroderma, consult your health care professional before planning to have a baby. You may need to adjust your medications and address specific risks with your doctor beforehand. Many women with scleroderma have successfully had children, but it is always considered high risk and extra monitoring and precautions are necessary, both before and during the pregnancy. And patients with rapid onset or severe internal organ involvement may need to postpone pregnancy until the symptoms subside or until toxic treatments are finished. Some women with severe scleroderma may be advised to forego pregnancy or consider adoption or surrogate parenthood instead. Discuss your decision with your health care provider.

9. Are medications available to treat scleroderma?

   Drugs that tamp down the immune system may be prescribed, as well as low-dose aspirin, glucocorticoids, diuretics, nonsteroidal anti-inflammatory drugs for pain, topical antibiotics for finger sores, ACE inhibitors and calcium channel blockers to keep arteries clear and vasodilators for Raynaud's phenomenon. Be sure to ask your health care professional about side effects.

10. What is Raynaud's phenomenon?

    Almost every scleroderma patient has this condition. Raynaud's can involve an abnormal sensitivity to cold in the extremities, a temporary change in color and sensation in the fingers and toes, changes in skin color, pain and occasionally ulcers of the fingertips or toes. If you have Raynaud's, there are some basic lifestyle changes you can make to prevent or decrease the severity of the symptoms, such as dressing warmly and limiting outdoor activities in cold weather.