Overlooked Manifestations

Systemic sclerosis (SSc) is a heterogeneous disease with well-described traditional clinical manifestations, such as Raynaud’s phenomenon, dermal sclerosis, esophageal dysmotility, calcinosis, and telangiectasia. Because the clinical presentation can be complex and involve multiple organ systems, there are several other manifestations that often go unrecognized but cause significant morbidity. This chapter discusses a few such manifestations, including oral complications, audiovestibular disease, thyroid dysfunction, liver disease, bladder dysfunction, erectile dysfunction, avascular necrosis of bone, and neurological manifestations.