Lee Claudia, Garg Neha, Mengden-Koon Stephanie, Fett Nicole
Dermatology, Oregon Health and Science University, Portland, USA.
Rheumatology, Northwest Rheumatology Associates, Portland, USA.
Cureus. 2025 Aug 15;17(8):e90182. doi: 10.7759/cureus.90182. eCollection 2025 Aug.
Systemic sclerosis is an autoimmune connective tissue disease, which is characterized by immune dysregulation and progressive sclerosis of the skin with variable internal organ involvement. Exogenous triggers such as physical trauma are documented as a potential precipitating factor for systemic sclerosis; however, the condition typically presents with bilateral skin changes. Unilateral progression of systemic sclerosis is an extremely rare phenomenon, and the role injury and/or immobilization plays in provoking this presentation requires further elucidation. A 63-year-old female with an 11-year history of limited cutaneous systemic sclerosis presents with rapidly progressive sclerosis confined to her right hand and wrist following a radial fracture and six months of immobilization. Examination revealed increased swelling and stiffness, considerably decreased range of motion, and progressive sclerodactyly of all five digits. MRI, blood cultures, and venous ultrasound were unremarkable. A punch biopsy was performed, and the histologic findings were consistent with scleroderma. We report a unique case of unilateral progression of limited cutaneous systemic sclerosis after injury and immobilization, which highlights the potential role of trauma and immobilization in the pathogenesis of systemic sclerosis.
系统性硬化症是一种自身免疫性结缔组织疾病，其特征为免疫失调以及皮肤进行性硬化，并伴有不同程度的内脏器官受累。诸如身体创伤等外源性触发因素被记录为系统性硬化症的潜在诱发因素；然而，该病症通常表现为双侧皮肤改变。系统性硬化症的单侧进展是一种极为罕见的现象，损伤和/或固定在引发这种表现中所起的作用需要进一步阐明。一名63岁女性，有11年局限性皮肤型系统性硬化症病史，在桡骨骨折并固定6个月后，出现局限于右手和腕部的快速进行性硬化。检查发现肿胀和僵硬加剧，活动范围明显减小，所有五指均出现进行性指硬皮病。磁共振成像、血培养和静脉超声检查均无异常。进行了钻孔活检，组织学结果与硬皮病相符。我们报告了一例损伤和固定后局限性皮肤型系统性硬化症单侧进展的独特病例，这突出了创伤和固定在系统性硬化症发病机制中的潜在作用。
