You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 34-year-old female presents with hypertension, pinched facies and progressive dysphagia with decreased tone of lower esophageal sphincter (LES) The clinical diagnosis is? and explain in detail?
Ans. A SclerodermaRef: CMDT 2019 page 323* Pinched facies with hypertension points to presence of scleroderma. The tone of LES is reduced in scleroderma due to fibrosis.* Choice B and C can lead to GERD but it does not have other features like systemic hypertension.* Choice D presents with chest pain and dysphagia and is hence ruled out.