A 52 year old woman with a 25 year history of Raynaud's phenomenon, suffering from diffuse arthralgia and vasculitic lesions on the hands for the last 5 years.
At physical examination, she had several telangectatic mats with polygonal shape on the face and extremities which closely resembled those seen in systemic sclerosis.
The hands were diffusely erythematous with sparse irregular atrophic scars on the palmar surface of the fingers and on the periungual folds. No signs of sclerodactyly or proximal scleroderma were evident.
Further clinical investigations revealed a scleroderma pattern (active) on capillaroscopy and a modest pericardial effusion. Antinuclear autoantibodies on HEp-2 cells with a speckled pattern and anti-nRNP were found.
After resolution of the pericardial effusion she was discharged on prednisone (10 mg/d) and nifedipine (20 mg/d).