True about generalized systemic sclerosis -

Raynaud's phenomenon is a universal feature and can precede other features by many years in systemic sclerosis . Involvement of small blood vessels in the extremities may cause critical tissue ischaemia, leading to localised distal skin infarction and necrosis. Skin Involvement proximal to the knee and elbow and on the trunk is classified as 'diffuse disease' (dcSScl) . Anti-centromere antibodies (ACAs; often styled solid, anticentromere) are autoantibodies specific to centromere and kinetochore function. They occur in some autoimmune diseases, frequently in limited systemic scleroderma (formerly called CREST syndrome), and occasionally in the diffuse form of scleroderma. Ref - Davidsons 23e p1037