Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications

A 60‐year‐old man with a significant 20‐year history of smoking, averaging approximately 20 cigarettes per day, presented with type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Over the preceding three months, the patient reported recurrent episodes of acrocyanosis and erythema of th...

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Main Author: Angelo Nigro
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11784
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author Angelo Nigro
author_facet Angelo Nigro
author_sort Angelo Nigro
collection DOAJ
description A 60‐year‐old man with a significant 20‐year history of smoking, averaging approximately 20 cigarettes per day, presented with type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Over the preceding three months, the patient reported recurrent episodes of acrocyanosis and erythema of the hands that were primarily induced by cold exposure. A capillaroscopy conducted in November 2024 revealed a “scleroderma‐like pattern” that was characterized by enlarged capillaries, megacapillaries, and a capillary density of fewer than eight capillaries per millimeter. Comprehensive immunologic and instrumental assessments demonstrated no evidence of systemic involvement or autoimmune disease. This case emphasizes the need to recognize the substantial role of cardiometabolic risk factors, including smoking, diabetes, hypertension, and hypercholesterolemia, in contributing to capillaroscopic abnormalities that may mimic systemic sclerosis. In this patient, the cumulative impact of these cardiometabolic factors culminated in the establishment of an “scleroderma‐like pattern” observed on nailfold capillaroscopy.
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spelling doaj-art-c46e1a188947482d82ebcad58422fc0e2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11784Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic ImplicationsAngelo Nigro0Madonna delle Grazie Hospital Matera ItalyA 60‐year‐old man with a significant 20‐year history of smoking, averaging approximately 20 cigarettes per day, presented with type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Over the preceding three months, the patient reported recurrent episodes of acrocyanosis and erythema of the hands that were primarily induced by cold exposure. A capillaroscopy conducted in November 2024 revealed a “scleroderma‐like pattern” that was characterized by enlarged capillaries, megacapillaries, and a capillary density of fewer than eight capillaries per millimeter. Comprehensive immunologic and instrumental assessments demonstrated no evidence of systemic involvement or autoimmune disease. This case emphasizes the need to recognize the substantial role of cardiometabolic risk factors, including smoking, diabetes, hypertension, and hypercholesterolemia, in contributing to capillaroscopic abnormalities that may mimic systemic sclerosis. In this patient, the cumulative impact of these cardiometabolic factors culminated in the establishment of an “scleroderma‐like pattern” observed on nailfold capillaroscopy.https://doi.org/10.1002/acr2.11784
spellingShingle Angelo Nigro
Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
ACR Open Rheumatology
title Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
title_full Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
title_fullStr Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
title_full_unstemmed Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
title_short Multifactorial Induction of a “Scleroderma‐Like Pattern” Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications
title_sort multifactorial induction of a scleroderma like pattern without underlying connective tissue disease diagnostic and therapeutic implications
url https://doi.org/10.1002/acr2.11784
work_keys_str_mv AT angelonigro multifactorialinductionofasclerodermalikepatternwithoutunderlyingconnectivetissuediseasediagnosticandtherapeuticimplications