Erectile Failure in Systemic Sclerosis

To the Editor: Krane et al. (Dec. 14 issue) 1 have provided a comprehensive review of the pathophysiology, diagnosis, and treatment of impotence. Common causes of male erectile failure are categorized according to evolving concepts of pathophysiology. We would like to emphasize the association of impotence with systemic sclerosis (scleroderma), since this may be an early presenting symptom of this rheumatic disease. Impotence in association with systemic sclerosis was first described in 1981 2 and was attributed to microvascular abnormalities, neurogenic abnormalities, or both. In a recent review of systemic sclerosis, 3 we noted the occurrence of erectile failure in 7 of 24 . . .