Scleroderma-like reactions

Solvents have been reported as predisposing or eliciting factors in some patients with scleroderma-like reaction. The reaction is suspected to result from repeated cutaneous contact with the solvent. The pathogenic mechanism is unknown. Walder (1983) reported six scleroderma patients who had close contact with aromatic hydrocarbon solvents, such as benzene, toluene and white spirit. Unlike chlorinated hydrocarbons, these aromatic hydrocarbons do not produce multisystem disease resembling vinyl chloride disease. The associated scleroderma is limited to the skin of hands and feet where the direct contact took place. 

In addition, silicone-containing medical devices, particularly breast prostheses, have been reported to cause serum-sickness-like reactions, scleroderma-like lesions, and an SLE-like disease termed human adjuvant disease [11,23]. Some patients may also present with granulomas and autoantibodies. Human adjuvant disease is a coimective tissue or autoimmune disease similar to that of adjuvant arthritis in rats and rheumatoid arthritis in humans. Autoimmime disease-like symptoms usually develop 2-5 y after implantation in a small percentage of people that receive implants, which may indicate that there is a genetic predisposition similar to that for... 

Penicillamine is a chelating agent which binds copper, mercury, zinc, and lead. It has been used to treat poisoning from these chemicals and also for disorders of copper metabolism such as Wilson s disease and primary biliary cirrhosis. Penicillamine has been tried in scleroderma and arthritis. Hypersensitivity reactions are common. About 20%-30% of the patients show hypersensitivity reactions suchs as morbilliform exanthema, urticaria, purpura, anorexia, lymphadenopathy, leukopenia, and thrombocytopenia (Meyboom 1975 Balme and Huskisson 1977). More severe skin symptoms associated with penicillamine therapy are Stevens-Johnson syndrome, pemphigus, myasthenia gravis, cholestatic jaundice (Barzilai et al. 1978), nephropathy (Lange 1978) and lupus-like syndrome (Harpey et al. 1972). 

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