Scleroderma and erosive polyarthritis: a disease entity?

We describe 4 patients with scleroderma in whom a major clinical feature was a deforming, erosive polyarthritis accompanied by positive tests for rheumatoid factor. In all but 1 case the skin involvement preceded joint symptoms, and in some cases there was evidence of systemic involvement. This destructive arthritis may represent the coexistence of 2 diseases or an extreme form of the inflammatory arthritis seen in scleroderma. Alternatively, the clinical presentation may represent an 'overlap syndrome' with features of both scleroderma and rheumatoid arthritis.