A 25-year-old lady presents with inability to form a fist and marked stiffening of joints. Diagnosis is.

Ans. (b) Scleroderma.Notice the shiny stretched skin with erythematous patches which are seen in scleroderma. These patients develop leather like skin which explains development of inability to form a fist. Also the fingers are tapered due to loss of pulp. ANA, Anti-Scl 70 and anti-topoisomerase antibody will be used to confirm the diagnosis.MORPHEA-Morphea, also called localized scleroderma or circumscribed scleroderma, is a form of that involves isolated patches of hardened skin on the face, hands, and feet, with no internal organ involvement.COUP DE SABRE-Frontal linear scleroderma (also known as en coup de sabre or morphea en coup de sabre) is a type of linear scleroderma characterized by a linear band of atrophy and a furrow in the skin that occurs in the frontal or frontoparietal scalp.RHEUMATOID ARTHRITIS-noun: rheumatoid arthritisa chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. Image source- style="font-family: Times New Roman, Times, serif">