امرأة عمرها ٣٥ سنة عندها أصابع تبيض ثم تزرق ثم تحمر مع البرد منذ سنتين، والآن جلد الأصابع والوجه صار مشدوداً وسميكاً، وصعوبة في البلع، وحرقة. ما الأرجح؟

A 35-year-old woman has had fingers turning white, then blue, then red in the cold for two years; now the skin of her fingers and face is tight and thick, with difficulty swallowing and heartburn. What is most likely?

1. Systemic sclerosis
2. Rheumatoid arthritis
3. Systemic lupus
4. Frostbite

Answer: A) Systemic sclerosis. Raynaud’s with skin thickening and dysphagia (oesophageal involvement) indicates systemic sclerosis; pulmonary pressures and kidneys are monitored and fingers protected from cold.