Systemic sclerosis. The role of the mast cell and cytokines.

This review of SSc has addressed the clinical features, pathophysiology involving the mast cell, T cell cytokines, and their interaction with other inflammatory cells (Figs 4 and 5). Therapeutic dilemmas and the future use of immunomodulatory therapy is also discussed. The allergist-immunologist may be the first physician to identify this insidious condition, since patients may present with cutaneous changes, swelling, pruritus, dyspnea, and with obstructive and restrictive findings on pulmonary function testing, or gastrointestinal symptoms, mimicking gastrointestinal hypersensitivity.