title: The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope.
abstract: Systemic sclerosis (SSc) is a disease of unknown causative factor that manifests as a heterogenous group of multiorgan system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Because of late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists.
authors.affiliation: Department of Medicine (LAS), Scleroderma and Sarcoidosis Patient Care and Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana; Institute for Health and Society Medical School (JHM), University of Oslo, Norway; Alexion Pharmaceuticals (MKD), Translational Medicine Group, Cambridge, Massachusetts; and Tulane Xavier National Center of Excellence in Women's Health (JHM, MKD), The Mary Amelia Douglas-Whited Community Women's Health Education Center and Tulane University School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.
authors.forename: Lesley Ann
authors.initials: LA
authors.lastname: Saketkoo
authors.forename: Jeanette H
authors.initials: JH
authors.lastname: Magnus
authors.forename: Mittie K
authors.initials: MK
authors.lastname: Doyle
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000517:prevention & control; D058007:Physicians, Primary Care; D015995:Prevalence; D012017:Referral and Consultation; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy