The skin can act as a very visible organ for the diagnosis and monitoring of connective tissue disease. A careful examination of the skin and mucous membranes may demonstrate specific or nonspecific signs, which aid in the diagnosis of these disorders and therefore the early institution of appropriate therapy.
- A multitude of skin signs may be helpful in making the diagnosis or following the course of a connective tissue disease.
- On the scalp and face, look for alopecia, scaling plaques, telangiectasia, erythema, oedema, nodules, photosensitivity and loss of expression.
- Signs on the trunk include induration, oedema, erythema and photosensitivity.
- Signs on the limbs include nodules, livedo, ulceration and punched-out lesions.
- Signs of connective tissue diseases are notably seen on the hands and feet. Look for nail changes, lesions on the fingertips, nodules, erythema, oedema, hyperkeratotic plaques and shiny skin.
- The severity of skin signs is not necessarily proportional to the extent of visceral involvement: severe disease is sometimes accompanied only by fleeting, subtle or very localised skin disease.