Clinical aspects of localized and systemic sclerosis.

Now that renal disease is no longer the leading cause of death in patients with systemic sclerosis, attention has shifted to cardiopulmonary involvement. Several reports addressed the issue of whether the pulmonary vasculature in patients with systemic sclerosis is vasoactive or fixed, and one report addressed the use of high-resolution computed tomographic lung scan to diagnose active alveolitis. The issue of whether the clinical syndrome of thrombotic thrombocytopenic purpura in systemic sclerosis is part of, or is distinct from, scleroderma renal crisis has again been raised. Worsening of cutaneous and visceral systemic sclerosis following radiotherapy was noted in several reports.