The first signs of Scleroderma include:

• Raynaud’s phenomenon: Approximately 90% of patients will experience this. Blood circulation is reduced due to excess collagen causing narrowing of small blood vessels. The fingers and toes often turn white or purplish triggered by cold temperatures or emotional stress. In more severe cases, this may lead to ulcers.
• Skin: This usually starts as puffy or swollen fingers and toes in both hands and feet, followed by thickened or hardened skin. There may be intense itch and skin inflammation initially. The skin often feels tight and this may lead to difficulty in bending or straightening the fingers.

Other symptoms and signs may include:

• Joints: Pain and swelling (or arthritis)
• Muscles: Muscle weakness, especially in the upper arms or thighs
• Telangiectasia: Small clusters of dilated blood vessels that appear as red spots may develop on the hands and face. These spots are not painful, but can cause cosmetic problems.
• Heart: Chest pain or irregular heart beat
• Lung: Shortness of breath or persistent coughing
• Digestive system: Heartburn with acid reflux, swallowing difficulties, bowel constipation, diarrhea or weight loss
• Kidneys: Fatigue with very high blood pressure
• Calcinosis: Calcium deposits form under the skin around the elbows, knees or fingers, appearing as hard, whitish areas. These deposits may be painful and break through the skin to form ulcers.
• Salivary glands and tear ducts: Dry mouth and eyes
• Dental health: Tooth decay may occur due to difficulty in opening the mouth to brush the teeth (caused by tight facial skin), gum retraction and dry mouth.