How is it Diagnosed?
Systemic sclerosis (scleroderma) is diagnosed based on clinical features, laboratory
tests, and imaging studies. The diagnosis begins with a detailed clinical examination,
focusing on hallmark symptoms such as skin thickening, Raynaud's phenomenon
(fingers turning white or blue in response to cold), digital ulcers, and joint stiffness.
Laboratory tests play a pivotal role in confirming the autoimmune nature of the disease.
Antinuclear antibody (ANA) testing is usually positive in most patients. More specific
antibodies include anti-centromere antibodies (common in limited cutaneous form) and
anti-Scl-70 (anti-topoisomerase I) antibodies, which are associated with diffuse
cutaneous systemic sclerosis.
Nailfold capillaroscopy, a non-invasive test to observe capillary abnormalities near the
fingernails, is commonly used in the early detection of systemic sclerosis, especially in
patients with Raynaud’s phenomenon.
Imaging and functional studies are essential to assess internal organ involvement. Highresolution CT scans of the chest help detect interstitial lung disease. Echocardiography
and pulmonary function tests evaluate heart and lung complications. Renal function
tests and urinalysis are used to detect scleroderma renal crisis.
A diagnosis is confirmed based on the 2013 ACR/EULAR classification criteria, which
include clinical features, antibody profiles, and organ involvement. Early diagnosis
allows timely initiation of treatment to slow progression and manage complications
effectively.