Scleroderma

Recently we had a very interesting mid 30 year old white female visit the voice clinic because of progressive hoarseness. She arrived with the diagnosis of Scleroderma. Scleroderma is a rare connective tissue disease affecting women more than men. Occurs most frequently between 30-50 years old and more in Choctaw American Natives and Afro Americans. Much less frequent in Americans of European descent.  The etiology (cause) is unknown, but the immune system plays a large role. There does seem to be a genetic susceptibility and it can be triggered in those susceptible individuals by certain pesticides and epoxy solvents and resins. The connective tissues, Muscles, ligaments , tendons etc. become over ridden with abundant collagen depositions.  Therefore the skin can become scarred with contractions  around the mouth and all openings. Blood vessels shrink and blood flow to vital organs is decreased. Anyhow, i have attached this persons video strobe and scope . You will note a very large collagen deposit in the anterior portion of the right vocal fold. We recommended intense voice therapy to stretch  and loosen the vocal fold. I was very hesitant to suggest surgical excision and feel this would certainly make her much worse. depending on her vocal progress i may inject steroids into the fibrous mass to see if it can be broken down in some way. Hopefully you can enjoy the video. This poor beautiful lady had many other problems with more vital organs as well. Thanks, Curt R Stock MD