Ans. (b) Scleroderma.Notice the shiny stretched skin with erythematous patches which are seen in scleroderma. These patients develop leather like skin which explains development of inability to form a fist. Also the fingers are tapered due to loss of pulp. ANA, Anti-Scl 70 and anti-topoisomerase antibody will be used to confirm the diagnosis.MORPHEA-Morphea, also called localized scleroderma or circumscribed scleroderma, is a form of that involves isolated patches of hardened skin on the face, hands, and feet, with no internal organ involvement.COUP DE SABRE-Frontal linear scleroderma (also known as en coup de sabre or morphea en coup de sabre) is a type of linear scleroderma characterized by a linear band of atrophy and a furrow in the skin that occurs in the frontal or frontoparietal scalp.RHEUMATOID ARTHRITIS-noun: rheumatoid arthritisa chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. Image source- style="font-family: Times New Roman, Times, serif">