A little understood disorder, scleroderma is a particularly thorny medical problem: neither cause nor cure is known, and the disease presents in multiple guises. This slender, sympathetic guide sets out clearly and comprehensively what is known about occurrence and treatment. Rheumatologist Mayes (Wayne Sate University School of Medicine) brings nearly 20 years of practice to bear here; she defines scleroderma as an autoimmune disease (meaning the body’s immune system attacks its own tissue as though it were a foreign invader) that affects blood vessels and connective tissue. It can occur in localized or systemic form and, as Mayes repeatedly points out, is a disease “characterized by exceptions”. Mayes discusses who gets scleroderma (women much more frequently than men; it doesn’t seem to run in families) and the myriad ways it can affect the body (from thickened, tight skin to kidney failure). Possibilities for treatment and symptom control are laid out, and Mayes attends to psychological and social issues of living with such a variable disease. She is impatient with the current fad of considering disease as an opportunity for growth: “Getting a diagnosis of a chronic, possibly debilitating disease is not good news, and no matter how you rephrase it, it is very difficult to see it as an opportunity.” But she is clearly sympathetic, admiring the courage of those struggling with this disorder. A sound resource, both informative and practical.