T.P., a 48-year-old African American woman with known

T.P., a 48-year-old African American woman with known limited cutaneous scleroderma, presents to your outpatient clinic complaining of pain and discoloration of the fingers on both hands. She describes discoloration as an intermittent loss of color from normal to a pale appearance, and the pain as intermittent numbness and tingling accompanying the loss of color. T.P. states the symptoms only appear when she is exposed to a cold environment. These symptoms are interfering with her quality of life and activities of daily living. In terms of other symptoms, T.P. also experiences intermittent development of thickened, pitted, rough skin patches located distal to her elbows bilaterally. She has no other significant past medical history, nor takes any medications on a regular basis. The physical examination findings revealed patches of skin thickening and nonpitting induration on upper torso. Telangiectasias are also noted in this area. Laboratory samples drawn last week show her ANA is negative and the basic metabolic panel, complete blood count, and liver function tests are all normal. What subjective and objective data present in T.P.’s case are consistent with limited cutaneous scleroderma?

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