Body Image Distress in Scleroderma

Changes in appearance are a common and distressing aspect of scleroderma. Disfigurement in scleroderma often occurs in areas of the body that are both visible and socially relevant (e.g., face and hands), which can contribute to increased social anxiety and avoidance. A case study is provided to share examples of common concerns and challenges associated with treating patients with scleroderma who are experiencing body image distress. Social, self-esteem, mood, and sexual impacts of body image distress are also discussed. The presence of significant body image concerns is not always associated with severity of appearance changes, thus open communication around changes in appearance is important regardless of perceived severity. Referrals to mental health professionals should be initiated as appropriate.