Decreased tone of the lower esophageal sphincter is one of the symptoms of scleroderma esophagus, which refers to scleroderma, also known as progressive systemic sclerosis, involving the esophageal musculature to develop its kinetic abnormalities. Scleroderma is a connective tissue disease that affects the fibrous tissue and small blood vessels of several organs. When the esophagus is involved, it leads to esophageal smooth muscle spasm and ischemia, as well as smooth muscle atrophy and submucosal collagen deposition and fibrosis formation. Raynaud’s phenomenon is often an early manifestation of PSS. The sites of capillary dilatation seen in PSS are usually the sites of predilection for Raynaud’s phenomenon, namely the face, tongue, lips, hands, and upper chest. In scleroderma, 95% of patients have Raynaud’s phenomenon, and 75% of them have Raynaud’s phenomenon as the first symptom. These patients often have visceral damage, and the prognosis and final outcome of scleroderma depends largely on the extent and severity of vascular damage. Causes Scleroderma is a connective tissue disease affecting the fibrous tissue and small blood vessels of multiple organs when the esophagus is involved leads to ischemia of esophageal smooth muscle spasm as well as smooth muscle atrophy and submucosal collagen deposition and fibrosis formation. 1, immune theory: the disease is often combined with LE dermatomyositis rheumatoid arthritis and other autoimmune diseases there are a variety of autoantibodies in the serum although the role of these autoantibodies in the pathogenesis is not clear, but has been found to be associated with the type of disease. 2, abnormal collagen synthesis theory: it is now clear that the tautness and hardness of scleroderma skin is due to the newly synthesized collagen replacing most or all of the dermis and (or) subcutaneous fat so that the skin clings to its underlying tissue. 3, vascular theory: Raynaud’s phenomenon is often the early manifestation of PSS PSS can be seen in the capillary dilatation site is usually a good site for Raynaud’s phenomenon, namely the face tongue lips hands and upper chest in scleroderma 95% of patients have Raynaud’s phenomenon, of which 75% have Raynaud’s phenomenon as the first symptom these patients often have visceral damage and the prognosis and final outcome of scleroderma depends largely on the extent and severity of vascular damage The prognosis and final outcome of scleroderma depend largely on the extent and severity of vascular damage. Other rare fungal infections include Aspergillus, Histoplasma, Cryptococcus, and Bacillus.