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Q. My cuticles have developed blood specks. Is it scleroderma?

Answered by
Dr. Ashaq Hussain Parrey
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 01, 2018 and last reviewed on: Oct 19, 2019

Hi doctor,

I am contacting you because I have Raynaud's, and 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.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

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 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 your self a diagnosis.

For more information consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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Thank you doctor,

I appreciate this so much. Would you say the condition is likely or just possible? I have not seen any other explanation for these doubts.

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

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 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 raynauds 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.

For more information consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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Thank you doctor,

I looked up clubbing. Is this going to progress? More importantly, it said the causes include lung cancer. I am 26 years old but I do smoke. Could it be that? And are you saying clubbing is not related to scleroderma?

Dr. Ashaq Hussain Parrey

General Medicine Internal Medicine Rheumatology
#

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 which you are saying associated with cancer first presents with cancer and then leads to clubbing the best thing is 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 feature of scleroderma.

For more information consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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