A Case of progressive Systemic Sclerosis with Silicosis / 대한피부과학회지

ABSTRACT

Scleroderma is sclerosis of the skin characterized by the appearance of circumscribed or diffuse hard, smooth, ivory-colored anea that are immobile upon the underlying tissues and give the appearance of hide-bound skin. Several environmental factors and chemicals have been described as being able to induce systemic scleroderma and scleroderma-like diseases. A possible association between scleroderma and workers exposed to silica has been suggested by reports in the literature since the turn of the century. We report a 55-year-old man, with a history of Raynaud's phenomenon and dysphagia, who had been exposed to silica dust over fifteen years. He had a mask-like face, flexian deformity of fingers, and hyperpigmented induration on the skin of all the extremities and the trunk. Antinuclear antibodies were positive in nucleolar type. On radiologic study, streaky, mottled, and nodular increased densities were noted in the both lung fields and these findings were consistent with silicosis. Endoscopic and manometric examination of the esophagus represented scleroderrna esophagus. Histopathological findings were compatible with scleroderma. He was treated with azathioprine and nifedipine with good improvement.