My cuticles have developed blood specks. Is it scleroderma?

Question

Hi doctor,

I am contacting you because I have Raynaud's, and in the past few months my cuticles have developed blood specks. I know these symptoms point to scleroderma. It has me very worried. I need to visit a doctor for tests but I have to wait a few days and I would really like to get some clarification on a few things. I get the impression that once you show these signs of specks in cuticles it definitely indicates scleroderma or some other autoimmune issue. Is it possible that I am wrong? I stopped getting manicures and the cuticles started getting very overgrown. Is it possible the specks in my cuticles are just because of this? Or maybe because my hands are dry and I have many hangnails? Another question I have is if I do ultimately have limited scleroderma CREST, is it common for these CREST patients to develop full-blown diffuse scleroderma? I am very stressed out about this. I am 26 years old female. Currently, I am taking Adderall and Citalopram.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your post. The diagnosis of scleroderma is based on clinical and some laboratory parameters neither Raynauds nor the cuticle blood spots are specific for scleroderma. It is skin thickness that has a maximum value and blood tests like anticentromere antibody and anti-Scl 70, which has significance the blood vessels involvement is microscopic and is seen only with NFC (near-field communication) not by the naked eye and only ulcers if present can be seen by naked eye. So do not panic get tested and examined before you give yourself a diagnosis.

I hope this addresses your concerns.

Please feel free to follow up if you have any further questions.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Because you have sent images (attachment removed to protect patient identity) so let me tell you that scleroderma causes vasculopathy which involves the tip of fingers which is the most distal part of the finger. A nail fold capiliroscopy will confirm. Actually, I can see there is grade-one clubbing which is causing this edema. Because Raynaud is seen in many conditions or sometimes has benign etiology so needs to be investigated. However, I do not see any signs of scleroderma because I do not see skin thickness. It is just graded 1 clubbing.

I hope this helps.

Please revert in case of further queries.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

Clubbing is not always progressive and not always due to cancer. Raymond's can also cause mild clubbing and the clubbing that you are saying is associated with cancer first presents with cancer and then leads to clubbing the best thing is to get investigated. Do ANA (anti-nuclear antibody), anti-Scl 70, anticentromere, ESR (erythrocyte sedimentation rate), and CBC (complete blood count). I do not see that you have any features of scleroderma.

I hope this helps.

Please revert in case of further queries.

Thank you.