Puffy hands and shiny skin in early systemic sclerosis

(A) Diffusely puffy fingers are a common initial presentation.
(B) Shiny skin suggests impending skin thickening.

Reprinted with permission from Systemic Sclerosis/Scleroderma: A Treatable Multisystem Disease, October 15, 2008, Vol 78, No 8, American Family Physician. Copyright © 2008 American Academy of Family Physicians. All Rights Reserved.

Graphic 96749 Version 2.0