A clinical guide to oral manifestations and diagnosis of limited systemic sclerosis: a case report

Scleroderma is a rare connective tissue disease involving vascular injury and autoimmunity. It is characterized by the thickening, hardening, and tightening of connective tissues, leading to multifaceted complications. Scleroderma is classified into 2 forms, localized scleroderma and systemic sclerosis (SSc). The systemic form is further subdivided into limited SSc (formerly known as CREST syndrome) or diffuse SSc. This report describes the case of a 41-year-old woman with gingival pain, temporomandibular joint pain, frequent fevers, night sweats, excessive thirst, hunger, frequent urination, and weight gain. Her medical history included Sjögren syndrome and Raynaud phenomenon. Physical examinations revealed petechiae on the palms, lips, tongue, and soft palate; hypochromia of the lips; fibrosis; dry mouth; and active periodontal disease. Serologic test results were positive for anticentromere and antinuclear antibodies and negative for anti-topoisomerase I antibody, confirming the diagnosis of limited SSc. The oral manifestations were critical to the early diagnosis of limited SSc. Telangiectasia, labial fibrosis, and xerostomia were key indicators. Interdisciplinary collaboration between oral healthcare professionals and rheumatologists is essential for optimal patient management. Further research is needed to understand the underlying mechanisms of SSc and refine the diagnostic criteria.