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Sclerodactyly for further evaluation; rheumatoid factor and Anti-CCP negative; chest x-ray no ILD; treatment started under my thickening of the skin
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Rheumatic & Autoimmune Conditions
Question #10794
16 hours ago
45

Sclerodactyly for further evaluation; rheumatoid factor and Anti-CCP negative; chest x-ray no ILD; treatment started under my thickening of the skin - #10794

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Sclerodactyly for further evaluation; rheumatoid factor and Anti-CCP negative; chest x-ray no ILD; treatment started under my care January 2023; ANA profile negative; the phenotype of the disease is like scleroderma with sclerodactyly and thickening of the skin in the chest and the neck; not able to make a fist; start Mycophenolate in March 2023; September 2023 reports no improvement in skin stiffness and tightening and joint pain; consider Rituximab after reports-- RP 11 and RP 155 both 3 + strong positive; ; advised Rituximab INJ. Toritz RA 1 gm first dose in JAN 2024; second dose MARCH 2024;

Age: 45
Chronic illnesses: Sclerodactyly for further evaluation; rheumatoid factor and Anti-CCP negative; chest x-ray no ILD;
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Doctors’ responses

Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
3 hours ago
This appears to be a scleroderma spectrum disorder with sclerodactyly and RP11/RP155 positivity, refractory to mycophenolate, now on Rituximab. Monitoring should focus on skin score, muscle enzymes, and PFTs. If Rituximab shows insufficient response after a few months, consider biologic escalation or overlap-targeted treatment. Supportive Measures: Hand therapy and physiotherapy crucial for maintaining mobility Vitamin D3 and calcium if on steroids Low-salt, anti-inflammatory diet
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