Often forgotten manifestations of systemic sclerosis

Given the multisystem nature of systemic sclerosis (scleroderma), there are several clinical manifestations that often go unrecognized; yet they can cause significant morbidity and are challenging to manage. The topics covered in this article include osteolysis, avascular necrosis of the wrist, oral manifestations, erectile dysfunction, pharyngeal weakness, fecal incontinence, nonscleroderma renal disease, liver disease, thyroid disease, and neurological disease in the scleroderma patient.