Clinical manifestation

Skin: areas of hyperpigmentation alternating with hypopigmentation; overall appearance of tanned skin persists long after sun exposure; telangiectasias on face, neck, and periungual areas; skin of the hands sometimes edematous or indurated early, later sclerotic stage where skin is tight and shiny, with a loss of hair, decreased sweating, and loss of ability to make a skin fold; starts distally on the fingers; any area of the body ultimately may be involved; calcinosis on the fingers and extremities; reduced oral aperture (microstomia) from perioral involvement

Ears, nose and throat: xerostomia and xerophthalmia; vascular changes - Ray-naud phenomenon triggered by cold, smoking, or emotional stress; infarction and dry gangrene sometimes results from severe vasospasm

Musculoskeletal system: arthralgias and morning stiffness sometimes mimicking other systemic autoimmune diseases; hand and joint function may decline from skin tightening; acroosteolysis (i.e., resorption or dissolution of the distal end of the phalanx) sometimes occurs; flexion contractures

Neurologic system: trigeminal neuralgia; carpal tunnel syndrome Respiratory system: dry rales, indicating fibrosis

Esophageal sphincter incompetence Gastrointestinal system: reflux; esophagitis Barrett metaplasia; candidiasis; watermelon stomach or gastric vascular antral ectasia; primary biliary cirrhosis; malab-

sorption; atrophy of smooth muscle and fibrotic changes leading to decreased peristalsis throughout the gastrointestinal tract Renal system: renal failure; cardiac involvement: indicates poor prognosis; pericardial effusions with cor pulmonale; conduction abnormalities; infiltrative cardiomyopathy

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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