[Silicosis associated with scleroderma]

Such an association would not appear to be fortuitous since scleroderma is commoner in male miners than in women in general, whilst the predominance of the disease in the latter group is well known. The picture is that of generalised scleroderma without any special characteristics. Silicosis usually precedes the scleroderma. In general, the onset of scleroderma alters the chest X-ray appearance with the development of diffuse, non-cavitated macro-nodular opacities localised in the lower two-thirds of the lungs and in particular at the bases, without absolute symmetry. Several hypotheses may be advanced to explain this association. Irritation by dust in the presence of a particular underlying terrain may cause silicosis and the same terrain may be associated with the development of scleroderma. A second possibility is that of immune phenomena secondary to the pneumoconiosis which favourise the development of scleroderma.