Three distinct presentations of systemic sclerosis in patients with previous silica dust exposure

This case report encompasses three patients who had worked in the construction industry. All three patients had significant silica dust exposure and were subsequently diagnosed with systemic sclerosis (SSc). Despite variations in clinical presentation, including Raynaud’s phenomenon, small bowel involvement and skin thickening, commonalities in occupational history and smoking status underscore the potential role of silica exposure as a trigger for autoimmune diseases. Erasmus syndrome is a rare condition characterised by the coexistence of SSc and silicosis and is often associated with prolonged occupational exposure to silica dust. It is important to note that these patients did not present with silicosis or interstitial lung disease, which has historically been associated with Erasmus syndrome. These cases highlight the importance of understanding SSc’s potentially life-threatening aspects. It is associated with significant morbidity and mortality owing to multiorgan involvement. They also highlighted various clinical phenotypes of the disease, including serological tests and treatments.