Classification of Systemic Sclerosis Systemic sclerosis is classified as Limited systemic sclerosis (CREST syndrome) Generalized systemic sclerosis (with diffuse skin involvement) Systemic sclerosis sine scleroderma In limited systemic sclerosis (CREST syndrome—calcinosis cutis, Raynaud syndrome, esophageal dysmotility, sclerodactyly, telangiectasias), patients develop skin tightening over the face and distal to the elbows and knees and may also have gastroesophageal reflux disease.