Scleroderma Insights

In a case study by Phillips et al. (2025), a woman in her 70s with a history of breast cancer, now in remission, developed symptoms including skin tightness, difficulty breathing, and Raynaud's phenomenon—a condition where fingers and toes change color and feel numb in cold temperatures or stress. Her physical exam showed high blood pressure, low oxygen levels, hardened skin on the fingers (sclerodactyly), and lung crackles. Tests indicated kidney issues, high pressure in the right side of her heart, and bone scans showed signs of metastatic cancer. Treatment began for a possible scleroderma renal crisis, a life-threatening complication of scleroderma involving acute kidney failure.

The patient's scleroderma panel was positive, indicating an autoimmune response, and a biopsy confirmed recurrent breast cancer. Despite starting treatment with rituximab, a medication used for certain autoimmune diseases and cancers, the patient faced multiple complications and chose to enter hospice care. This case highlights the potential for scleroderma to be a paraneoplastic syndrome, where symptoms are the result of cancer in the body, emphasizing the need for thorough evaluation and collaborative treatment planning in new scleroderma cases.