A case of scleroderma associated with rheumatic fever.

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In this report we described a case of scleroderma associated with rheumatic fever. A 40-year-old male was admitted to our hospital because of polyarthralgia, cubital nodules with redness and pain of the elbows, and sclerodactyly. The diagnosis of rheumatic fever was confirmed by clinical features and high titer of ASK. After daily administration of 1.2 million unit of benzathine penicillin G was started, polyarthralgia and acute inflammatory reaction were improved but screlodactyly continued. Scleroderma was diagnosed because the histological findings in skin biopsy revealed a striking increase of compact collagen fibers in the deeper reticular dermis. D-penicillamine of 100mg per day was then started, and sclerodactyly was gradually improved. There have been no reports of scleroderma with rheumatic fever. This case was thought to be interesting in order to consider the pathogenesis of scleroderma, because both scleroderma and rheumatic fever are considered to be based on immunological disorder.