The systemic forms (limited or diffuse cutaneous) involve those and, in addition, may progress to visceral organs, including the kidneys, heart, lungs, and gastrointestinal tract. Prognosis is determined by the form of the disease and the extent of visceral involvement. Patients with limited cutaneous scleroderma have a 10-year survival rate of 75%; less than 10% develop pulmonary arterial hypertension after 10 to 20 years.