Abstract
IT HAS been established that scleroderma is a generalized disease. The condition usually runs a chronic course, but it may become acute, with fibrinoid change in the connective tissue like that seen in lupus erythematosus and periarteritis nodosa. 1 Therefore, it is not unusual that the following case showed both chronic and acute features of scleroderma, but it is unusual that in this case there was a sudden change from a chronic course to an acute fulminating, fatal course during corticotropin (ACTH) therapy. REPORT OF CASE This 48-year-old white man's illness began in the spring of 1949 with a short episode of involvement of the joints of the right arm and fingers. Following this, he had a nine-month asymptomatic period. In May, 1950, after an eight-week period of stiffness and swelling of the finger joints, wrists, ankles, and balls of the feet, he was admitted to Hines Veterans Administration Hospital.
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