DENNY L. TUFFANELLI, M.D.; R. K. WINKELMANN, M.D.
Most early classifications of scleroderma were based solely on the distribution of cutaneous lesions, and early texts (1, 2) divided scleroderma into localized and generalized forms only. Hutchinson (3) first associated scleroderma with Raynaud's phenomenon in 1896. The concept that there were 2 types of systemic scleroderma, "acrosclerosis" (scleroderma with Raynaud's phenomenon) and "diffuse scleroderma" (scleroderma without vasospastic change) was postulated by Sellei (4) in Europe, and by O'Leary and Waisman (5) in this country. This differentiation has many advocates (6-8), but many doubt its usefulness (9-12). As the multiple systemic findings of the disease became better known, other authors
TUFFANELLI DL, WINKELMANN RK. Diffuse Systemic Scleroderma: A Comparison with Acrosclerosis. Ann Intern Med. ;57:198–203. doi: 10.7326/0003-4819-57-2-198
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Published: Ann Intern Med. 1962;57(2_Part_1):198-203.
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