<prompt> A 35-year-old lady complains of dysphagia, Raynauds phenomenon and her hands show the following appearance. Investigations show positive ANA. The likely diagnosis isSystemic lupus erythematosusSystemic sclerosisMixed connective tissue disorderRheumatoid ahritis  <response>: Systemic sclerosisThe chronic disease is characterized by:1.cc inflammation, dt autoimmunity2.Widespread damage to small blood vesselsProgressive interstitial perivascular fibrosis in skin multiple organsReference: Harrison;s principles of Internal Medicine; 19th edition 