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Limited cutaneous systemic sclerosis — SCE Rheumatology MCQ

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ModerateConnective Tissue DiseasesLimited cutaneous systemic sclerosisSCE Rheumatology

A 67-year-old man has Raynaud's phenomenon, sclerodactyly distal to the elbows, telangiectasia, reflux, anti-centromere antibodies and reduced transfer factor. What is the most likely diagnosis?

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Correct answer: BLimited cutaneous systemic sclerosis

Limited cutaneous systemic sclerosis is the single best answer because anti-centromere-positive distal skin disease is typical of limited cutaneous systemic sclerosis. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Mixed connective tissue disease is less suitable because it fits a different clinical pattern or a different treatment threshold; Primary Sjögren's disease, Repeat ANA titre alone and Adalimumab do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR/EULAR connective tissue disease recommendations; BNF