A 43-year-old woman comes to the physician because of a 2-month history of pain and swelling in her wrists and hands. She has had a 5-kg (11-lb) weight loss over the past 2 months. Her temperature is 36.7°C (98.1°F), pulse is 75/min, and blood pressure is 150/80 mm Hg. Examination shows tightness of the skin of the fingers; there are small nonhealing, nonpurulent ulcers over thickened skin on the fingertips. Histologic sections show expansion of the dermal layer with atrophy of the intradermal adipose tissue and dermal appendages. High-power images of the dermis demonstrate extensive deposition of dense, eosinophilic connective tissue. This patient is most at risk for which of the following conditions?

Question

A 43-year-old woman comes to the physician because of a 2-month history of pain and swelling in her wrists and hands.  She has had a 5-kg (11-lb) weight loss over the past 2 months. Her temperature is 36.7°C (98.1°F), pulse is 75/min, and blood pressure is 150/80 mm Hg. Examination shows tightness of the skin of the fingers; there are small nonhealing, nonpurulent ulcers over thickened skin on the fingertips. Histologic sections show expansion of the dermal layer with atrophy of the intradermal adipose tissue and dermal appendages.  High-power images of the dermis demonstrate extensive deposition of dense, eosinophilic connective tissue.  This patient is most at risk for which of the following conditions?

Quizplus · Accepted Answer

Eductional Objective: Systemic sclerosis (SS) is an autoimmune disease characterized by the widespread fibrosis of multiple organ systems.  Histology demonstrates expansion of the dermal layer with diffuse collagen deposition and atrophy of the intradermal adipose tissue and dermal appendages.  Pulmonary complications are common (eg, interstitial lung disease, pulmonary hypertension).

A 43-Year-Old Woman Comes to the Physician Because of a 2-Month