CASE 26

Scleroderma

QUESTION 26

A 38-year-old woman presents with a history of edema in her hands, pain and stiffness in her fingers with colour changes during the winter. She complains of painful ulcerations on the digital pulp of her fingertips that heal with scars. She also notes areas of asymptomatic dilated blood vessels on her lips that she finds unsightly. On examination, there are pitted scars on the tips of the fingers with some associated atrophy (26).

i. Based on this patient’s clinical presentation, what is the most likely diagnosis?

ii. What basic laboratory studies can be performed to confirm the diagnosis and what additional screening tests can be performed?

Answer 26

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