Hand Swelling and Other Non–Raynaud Phenomenon Symptoms as the Initial Presentation of Systemic Sclerosis: Prevalence and Clinical Associations in Two <scp>US</scp> Cohorts
In two large US cohorts, >30% of patients began to manifest SSc with puffy fingers/hands or other symptoms, without the "warning sign" of RP as their initial symptom. These patients presented with more severe skin and musculoskeletal disease on average, highlighting the importance of early recognition. The most common autoantibody associated with this presentation was RNA polymerase III. These results should be considered in efforts to recognize SSc in its earliest stages. Puffy fingers/hands, even in the absence of RP, should prompt consideration of early SSc and testing for ANA and SSc-associated autoantibodies, including RNA polymerase III.
Authors
- Ami A. Shah (ORCID: https://orcid.org/0000-0002-1139-2009)
- Laura K. Hummers (ORCID: https://orcid.org/0000-0002-4864-4011)
- Leland W.K. Chung (ORCID: https://orcid.org/0000-0003-0072-6939)
- Duncan F. Moore (ORCID: https://orcid.org/0000-0001-9469-0919)
- Kimberly S. Lakin (ORCID: https://orcid.org/0000-0001-9343-5545)
- Yiming Luo (ORCID: https://orcid.org/0000-0001-7710-2425)
- Nora Sandorfi (ORCID: https://orcid.org/0009-0009-5877-3552)
- Elizabeth R. Volkmann (ORCID: https://orcid.org/0000-0003-3750-6569)
- Shervin Assassi (ORCID: https://orcid.org/0000-0002-8059-9978)
- Carrie Richardson (ORCID: https://orcid.org/0000-0002-2541-175X)
- Maureen D. Mayes (ORCID: https://orcid.org/0000-0001-5070-2535)
- Zsuzsanna H. McMahan (ORCID: https://orcid.org/0000-0001-6461-8940)
- Dorota Lebiedz‐Odrobina
- Elana J. Bernstein (ORCID: https://orcid.org/0000-0001-5560-6390)
- Kimia Ghaffari (ORCID: https://orcid.org/0009-0009-4748-144X)
- Virginia Steen (ORCID: https://orcid.org/0000-0002-6333-0133)
- Jessica S. Alvey (ORCID: https://orcid.org/0000-0002-8543-5884)
- Tracy Frech (ORCID: https://orcid.org/0000-0002-5472-3840)
- Carleigh Zahn (ORCID: https://orcid.org/0009-0005-9683-6973)
- Ankoor R. Shah (ORCID: https://orcid.org/0000-0002-6315-8089)
- Dinesh Khanna (ORCID: https://orcid.org/0000-0003-1412-4453)
- Luke Evnin
- Iqtidar Hanif
- Brian Skaug (ORCID: https://orcid.org/0000-0002-6689-4655)
- Jessica Gordon (ORCID: https://orcid.org/0000-0001-8068-0592)
- Flavia V. Castelino
- John M. VanBuren (ORCID: https://orcid.org/0000-0003-1350-5764)
- Ashima Makol (ORCID: https://orcid.org/0000-0002-8748-898X)
- Victoria K. Shanmugam (ORCID: https://orcid.org/0000-0002-5882-4884)
- Meng Zhang (ORCID: https://orcid.org/0000-0003-4935-4005)
- Julio Charles
- Jerry A. Molitor
- Faye N. Hant
Institutions
- Northwestern University (US)
- Hospital for Special Surgery (US)
- University of Minnesota (US)
- Mayo Clinic (US)
- Johns Hopkins University (US)
- Medical University of South Carolina (US)
- University of California, Los Angeles (US)
- Duke University (US)
- Georgetown University (US)
- George Washington University (US)
- VA Palo Alto Health Care System (US)
- University of Utah (US)
- University of Michigan (US)
- Columbia University Irving Medical Center (US)
- Georgetown University Medical Center (US)
- University of Minnesota System (US)
- Massachusetts General Hospital (US)
- VA Tennessee Valley Healthcare System (US)
- Mayo Clinic in Arizona (US)
- Scleroderma Foundation (US)
- Columbia University (US)
- University of Pennsylvania (US)
- Vanderbilt University Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
- Philadelphia University (US)
- Stanford University (US)
Publication Details
- Journal
- Arthritis & Rheumatology
- Published
- 2025-05-19
- DOI
- https://doi.org/10.1002/art.43237
- Citations
- 1
- Primary Topic
- Systemic Sclerosis and Related Diseases
- Type
- article
- Field-Weighted Citation Impact
- 1.47