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People may be at increased risk of systemic scleroderma if they: Have a first-degree relative (parent, sibling, or child) with scleroderma Have a first-degree relative with certain other autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, and thyroiditis (inflammation of the thyroid) Are female Are between 20 and 50 years of age Were exposed to silica dust, vinyl chloride, welding fumes, epoxy resins, paint thinners, paint removers, industrial solvents, or other chemicals Worked as a gold miner or coal miner Took certain medications, including the chemotherapy drug bleomycin, the opioid pentazocine, cocaine, hormone replacement therapy, or certain appetite suppressants Have certain gene mutations, especially in certain genes that play a role in the immune system Localized scleroderma has been associated with the following: Radiation therapy Certain infections, including cytomegalovirus and Borrelia burgdorferi (a species of bacteria known to cause Lyme disease), among others Certain medications, including the chemotherapy drug bleomycin and the opioid pentazocine, among others Skin injury—for instance, from surgery What are the symptoms of scleroderma