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3353 Pathology

A 45-year-old woman presents with a 4-month history of severe headaches and pain, and blanching of the hands upon exposure to cold. She is a nonsmoker. Over the past 6 months, she has noticed progressive difficulty in swallowing solid food. Physical examination reveals smooth and tight skin over the face and fingers. The serologic test for anti-Scl-70 (antitopoi-somerase) is positive. Painful hands in this patient are best described using which of the following terms?

AChilblains
BHomans' sign
CIntermittent claudication
DRaynaud phenomenon
Pathology
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