All of the following are features of scleroderma except:
**Core Concept**
Scleroderma, also known as systemic sclerosis, is a chronic autoimmune disease characterized by fibrosis and vascular alterations in the skin and internal organs. It involves the deposition of collagen and the proliferation of fibroblasts, leading to thickening and hardening of the skin and affected organs.
**Why the Correct Answer is Right**
Scleroderma is characterized by the presence of autoantibodies, particularly anti-Scl-70 (anti-topoisomerase I) and anticentromere antibodies. The disease also involves vascular damage, including Raynaud's phenomenon, which is a hallmark of the condition. Additionally, patients often experience fibrosis in various organs, such as the lungs, heart, and gastrointestinal tract.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because calcinosis, a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues, is actually a feature of scleroderma, not an exception.
**Option B:** This option is incorrect because telangiectasias, which are dilated blood vessels near the surface of the skin, are a feature of scleroderma, particularly in patients with limited systemic sclerosis.
**Option C:** This option is incorrect because esophageal dysmotility, a condition characterized by impaired movement of food through the esophagus, is a feature of scleroderma, particularly in patients with diffuse systemic sclerosis.
**Clinical Pearl / High-Yield Fact**
A key feature of scleroderma is the presence of autoantibodies, particularly anti-Scl-70 (anti-topoisomerase I) and anticentromere antibodies, which can help guide diagnosis and prognosis.
**Correct Answer:** D