title: Pigmented skin patches without scleroderma as a predominant clinical symptom revealing systemic sclerosis.
abstract: Skin induration remains the major clinical symptom of systemic sclerosis (SSc), an autoimmune disease with potentially life-threatening visceral involvement. However, skin induration can be absent in some patients, making the diagnosis difficult to confirm and leading to delay in management. Skin pigmentation abnormalities have been reported in patients with SSc, and can be important to recognize for diagnosis. We report two patients who developed hyperpigmented skin patches without any sign of scleroderma, as a major clinical skin symptom of incipient SSc.
authors.affiliation: Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint André, Bordeaux, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Darrigade
authors.affiliation: Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint André, Bordeaux, France.
authors.forename: A L
authors.initials: AL
authors.lastname: Vedie
authors.affiliation: Department of Vascular Medicine, Hôpital Saint André, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Gauthier
authors.affiliation: INSERM U1035, University of Bordeaux, Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Cario-André
authors.affiliation: Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint André, Bordeaux, France.|INSERM U1035, University of Bordeaux, Bordeaux, France.
authors.forename: A
authors.initials: A
authors.lastname: Taieb
authors.affiliation: Department of Rheumatology, Hôpital Pellegrin, Bordeaux, France.
authors.forename: M E
authors.initials: ME
authors.lastname: Truchetet
authors.affiliation: Department of Vascular Medicine, Hôpital Saint André, Bordeaux, France.
authors.forename: J
authors.initials: J
authors.lastname: Constans
authors.affiliation: Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Hôpital Saint André, Bordeaux, France.|INSERM U1035, University of Bordeaux, Bordeaux, France.
authors.forename: J
authors.initials: J
authors.lastname: Seneschal
mesh_terms: D000368:Aged; D001168:Arthritis / Q000209:etiology; D001706:Biopsy; D002114:Calcinosis / Q000209:etiology; D019937:Diagnostic Techniques and Procedures; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology*; D017563:Lung Diseases, Interstitial / Q000209:etiology; D020678:Microscopic Angioscopy; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology; D012867:Skin / Q000473:pathology*; D012883:Skin Ulcer / Q000209:etiology