Health
Finger colour changes may be sign of autoimmune disease — Experts
Medical experts have urged Nigerians not to ignore persistent swollen hands or changes in finger colour, warning that these symptoms could be early signs of Scleroderma, a rare autoimmune disease that can cause serious complications if left untreated.
They noted that early symptoms, including swollen fingers, puffy feet, swollen face, skin tightening, and colour changes in response to cold or stress, should not be overlooked or mistaken for less serious conditions.
The experts warned that delayed diagnosis and treatment could lead to serious complications that affect the lung, heart, digestive system, and kidneys.
Scleroderma is a rare condition that makes the body produce tissue that’s thicker than it should be, according to the Cleveland Clinic,
Scleroderma usually affects the skin, but can cause symptoms in any tissue throughout the body, it added.
“Scleroderma is a chronic condition, which means you’ll need to manage your symptoms for a long time (maybe the rest of your life). It can also cause life-threatening complications if it affects tissue in your organs,” the health website said.
Speaking exclusively with PUNCH Healthwise, Consultant Rheumatologist at the Lagos State University Teaching Hospital, Dr Hakeem Olaosebikan, explained that scleroderma occurs when the body’s immune system triggers excessive collagen production, leading to the hardening of the skin and damage to internal organs in some patients.
Olaosebikan, who spoke in commemoration of World Scleroderma Day, celebrated on June 29 yearly, said while scleroderma isn’t common, it can overlap with other autoimmune diseases.
According to him, scleroderma can occur together with lupus, rheumatoid arthritis, and some other autoimmune conditions.
“In scleroderma, the immune system is overactive or overactive and attacks the skin, the soft tissues, the blood vessels, the proteins that make up the skin, and the internal organs,” he said
He explained that scleroderma usually starts with swollen or puffy hands, puffy feet, a puffy face, or even swelling of the whole body before it progresses to hard skin.
“So, the early signs and symptoms often begin with puffy hands, where both hands become swollen and puffy, or puffy feet, a swollen face, or sometimes swelling of the entire body. People often mistake this for kidney disease, liver disease, insect bites, or allergic reactions.
“Another early symptom is recurrent episodes of discolouration of the fingers and toes, and sometimes the nose or ears. The fingers may change colour from white to blue to pink, or become dark, particularly after exposure to cold or emotional stress. So, patients experience painful discolouration of the fingers and toes, and sometimes the nose or ears. These episodes occur repeatedly,” he said.
The rheumatologist said the hard skin is usually a later presentation.
“After the first stage, patients gradually develop the thickening or hardening stage, where the skin becomes very hard, almost like leather. They are unable to pinch the skin over different parts of their body,” he said.
Olaosebikan explained that complications of the scleroderma include inflamed lung, abnormalities of the heart, digestive system, and the kidney.
He said, “The lungs may become inflamed and scarred, making it difficult for patients to breathe. They become easily tired after walking short distances, may develop persistent coughing, and in severe cases may become dependent on oxygen. The disease can also affect the heart. Patients may develop electrical abnormalities of the heart, known as arrhythmias, heart block, or fluid accumulation around the heart.
“It can also affect the digestive system. Patients may experience symptoms similar to heartburn, ulcers, or acid reflux. Sometimes, they may have bleeding and pass dark-coloured stools because of involvement of the digestive tract. They may also develop problems with digestion and nutrient absorption, meaning their food is not properly absorbed.
“The kidneys can also be affected. When this happens, it is usually a medical emergency. Patients may develop severe kidney problems accompanied by dangerously high blood pressure. Scleroderma can also affect the joints. Patients may develop deformities of the fingers and joints. The fingers may become shortened over time because the fingertips can undergo tissue death (gangrene), leading to loss of part of the fingers.”
He said people with a family history of autoimmune diseases, exposure to certain chemicals, and people working in construction, manufacturing, and petroleum industries are at risk of the condition.
“Generally, however, the major risk factors are genetic predisposition and family history. As the disease progresses, the skin becomes thickened and tight over different parts of the body. Patients cannot pinch the skin over their fingers, hands, feet, or other parts of the body because it has become hard.
“The skin may appear as though it has sustained a burn injury. It becomes thick, tight, and leathery. Patients also develop severe itching in different parts of the body. Their skin may become very dark, with patches of lighter and darker pigmentation occurring together,” he said.
The rheumatologist, however, said that the condition is often misdiagnosed as kidney or liver diseases.
He stressed that early diagnosis and appropriate treatment can help slow disease progression, reduce complications, and improve the quality of life of people living with scleroderma.
“Unfortunately, many patients are diagnosed late, as some are initially treated for kidney disease because of the swelling, others are treated for liver disease, while some are managed for allergic reactions, insect bites, or drug reactions.
“By the time they eventually see a rheumatologist, significant damage has already occurred. Their skin has already become severely hardened. They may no longer be able to open their mouths properly because the skin has become very tight and scarred. Some develop chronic wounds or ulcers on their fingers that refuse to heal because of longstanding, undiagnosed or misdiagnosed scleroderma. That is why awareness is very important,” he said.
Also, a Consultant Dermatologist at Lagos University Teaching Hospital, Dr Otrofanowei Erere, advised people living with scleroderma to stop using local concoctions to treat it and refrain from attributing the condition to a spiritual attack.
“When your skin is tightening, when your skin is hard, when you don’t understand what is happening to your skin, go and see a specialist. When you are not even sure of what the disease is, seek a second opinion.
“Though scleroderma has no cure, we can control the disease to prevent complications and improve quality of life. You can smile even with scleroderma when early detection is done,” she said.
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