Anti-nucleolar and speckled. The anti-centromere pattern is very specific for limited scleroderma although some patients with Raynaud's and this antibody will never develop any other features of scleroderma despite many years of follow up. The speckled pattern is very non-specific and seen in many conditions. The level of these antibody reactions does not in itself equate to any particular disease manifestation or outcome. These antibodies are regarded as markers or indicators of disease possibilities and their exact significance in causation of any problem is unknown.
Mild cases are more common than previously recognised.
At this end of the spectrum, patients have clinical involvement limited to the fingers and do not develop symptomatic organ involvement, except perhaps in the oesophagus. At the other extreme are cases with diffuse marked skin thickening involving most of the body and early severe internal organ involvement. The extent of skin involvement within one year of presentation can be a guide to predict outcome. It is extremely rare for a patient who, after one year of disease onset has limited disease, to progress to diffuse disease. Emotional problems Scleroderma, as with any chronic disease, is cause for emotional involvement.