<prompt> A 14 year old girl on exposure to cold has pallor of extremities followed by pain and cyanosis. In later stages of life she is most prone to develop:SLESclerodermaRheumatoid AhritisDermatomyositis  <response>: Answer is B i.e. Scleroderma: Pallor of extremities, followed by pain and cyanosis suggests a diagnosis of Reynauds Phenomenon. Reynauds phenomenon as the presenting manifestation is most strongly associated with scleroderma or systemic sclerosis. Reynauds Phenomenon and Scleroderma Reynauds phenomenon RP is the clinical syndrome of episodic color change of the digits in response to cold and in some patients, emotional stress. The typical sequence is pallor aerial constriction followed by cyanosis vasospasm and desaturation of hemoglobin. Reynauds Phenomenon is may be associated with a variety of connective tissue disorders including SLE, Rheumatoid ahritis, scleroderma and dermatomyositis all options provided in question, however its association with scleroderma is exceptionally strong. Secondary causes of Raynaud Phenomenon: Rheumatologic Hematologic disorders Systemic sclerosis scleroderma Cryoglobulinemia Systemic lupus erythematosus Paraproteinemia Rheumatoid ahritis Polycythemia Sjogren syndrome Cold agglutinins Dermatomyositis Polymyositis Vasculitis Mechanical Endocrine disorders Vibration injury Hypothyroidism Frostbite Carcinoid syndrome Thoracic outlet syndrome Pheochromocytoma Vascular embolus or occlusion Vasospasm Drugs Migraine headaches Sympathomimetics drugs decongestants, diet pills Serotonin agonists sumatriptan Chemotherapeutic agents bleomycin, cisplatin, carboplatin, vinvlastine Ergotamine tarate Caffeine Nicotine 