Hoar Loss and Sweat
After the acute phase, in which inflammation predominates, a more chronic phase appears with retraction of the skin, loss of hair and sweat, and the appearance of contractures that prevent bending of the fingers or wrist. In this phase, the skin involvement progresses from the fingers of the hands to the wrist and arms, and may even affect the trunk and face. This simultaneously leads to loss of hair and sweating in the associated area since the skin becomes shiny.
Scalp and face involvement
When the face is affected, facial features are sharpened (thin lips, “bird” nose, thinning of the auricles), vertical folds are formed around the mouth (purse-string mouth), the face becomes like a mask. Due to a decrease in elasticity and proliferation of fibrous tissue, the joints lose their mobility, contractures are formed limiting the range of motion in the joints, such as that of the jaw. The affectation of the skin of the face makes wrinkles disappear and it may be difficult to open the mouth or eyes.