Scleroderma is one of the conditions in the group of rheumatic diseases which affect the joints, muscles and the connective tissues of the body (skin, blood vessels, and internal organs). Distinctive abnormalities of the skin usually appear later in the course of the disease. Common symptoms of scleroderma may include painful joints, morning stiffness, fatigue, and/or weight loss. Cold temperatures may trigger the intermittent loss of blood supply to the fingers, toes, nose, and/or ears (Raynaud's phenomenon) and this is an early and frequent complaint of people with scleroderma. People with scleroderma have areas of skin that become hard and leathery (indurated). Symptoms of scleroderma can vary from mild to severe. It occurs more frequently in females than in males. The exact cause of scleroderma is unknown. In a number of cases scleroderma occurs in more than one individual in a family, and there are thought to be multiple causes. These include abnormal immune activity, potential environmental triggers, and an individualâ€™s genetic make-up. It is believed that the presence of certain genes may make it more likely that a person will develop the disease (ie. a genetic predisposition is present).