Question
Hello, I am very confused.
I had an appointment with my dermatologist, who advised uva treatment. I have subcutaneous morphea from breast tissue to under armpits down to elbows (both sides) and from inner thighs, to knees. a plaque on flank and one on hip. a large very thick (seems to be attached to muscle, on groin) and what looks like plaques developing from inner arms to wrist and knees to ankle.

Before I was diagnosed, I was for ever at my doctor, and referred to hospital, neurologist, numbness in legs gastro:.. reflux, had to have voice therapy,.... diagnosed with heart murmur........COPD

My confusion now, is, how does the dermatologist know, that there is NO internal damage, he said that the scl-70 and ana were normal. I don't want internal damage but would like to be sure that there isn't.

Than you Lynne

Answer
Lynne, the diagnosis in scleroderma is based on symptoms. history, and observation, so your doc didn't see or hear evidence of systemic scleroderma AND the ANA testing backed that up.  COPD and heart murmur aren't systemic scleroderma problems, and reflux is very common on its own.  You don't mention Raynaud's phenomenon, which is present in 95-98% of systemic cases.  If you don't have that, odds are you don't have one of the systemic varieties that can cause internal damage.

I understand your hesitancy - it's shocking to have these things going on with your skin and easy to tie other symptoms to it.  Be vigilant for new symptoms and take care of the whole you.