Scleroderma in an ice-cream shop worker.

The article describes the case of a 30-year old female ice cream vendor who was diagnosed with scleroderma (SSc). Physical examination showed severe hardening and thickening of the skin in her right hand which she uses for scooping ice cream compared to the left hand. Similar vascular abnormalities were noted in both hands but dermal sclerosis were limited to the right suggesting that there is hierarchical relationship between vascular abnormalities and skin fibrosis in SSc.