Orofacial manifestations of an overlap syndrome: a report of progressive polyautoimmunity

Autoimmune disorders exhibit several clinical symptoms, pathophysiological processes, and genetic components, which result in an autoimmune tautology, suggesting that they share similar etiological pathways. Systemic Sclerosis (SSc), also known as Scleroderma, is a potentially fatal systemic autoimmune connective tissue disease with a multifactorial pathogenesis and unknown etiology. The progression of the condition is characterized by substantial bone erosion at the muscle attachment sites. The co-existence of systemic sclerosis and rheumatoid arthritis in the same patient was debatable. Although some research has linked rheumatoid factor to erosive arthritis, indicating a possible overlap between the two conditions, other investigations have not supported these findings. Orofacial tissue involvement is a typical progressive systemic sclerosis (PSS) feature characterized by reduced mouth opening (microstomia), predominantly influenced by cutaneous involvement, and seldom by joint involvement. This report describes the orofacial symptoms of a 56-year-old female patient who had systemic sclerosis and rheumatoid arthritis that progressively coexisted.