Systemic disease may result in dysphagia through numerous mechanisms. For example, salivary gland impairment may result in xerostomia, which as well as resulting in painful mucosal blisters and ulcers may impair oral function. Acute or chronic inflammatory processes may result in strictures in the esophagus and/or pharynx. Furthermore, altered biomechanics of oral, pharyngeal, and esophageal musculature may be found in patients with rheumatoid arthritis with cervical spine abnormalities and in patients with scleroderma. Finally, systemic vasculitides involving the central nervous system may result in cortical and brainstem ischemia leading to neurological impairment hampering the swallowing process.