A 45-year-old female presents with a 10-year history of Raynaud's phenomenon, followed by telangiectasias on her face and hands, dysphagia due to esophageal dysmotility, and calcinosis cutis on her fingertips. Her skin thickening is limited to her hands and face. Which of the following is the most likely diagnosis?

Explanation

This patient presents with features of CREST syndrome (Calcinosis, Raynaud's, Esophageal dysmotility, Sclerodactyly, Telangiectasias) and skin thickening limited to the distal extremities and face, which are classic characteristics of limited cutaneous systemic sclerosis (lcSSc). Diffuse cutaneous systemic sclerosis involves rapid and widespread skin thickening, often affecting the trunk and proximal extremities, and is associated with a higher risk of early visceral organ involvement. Mixed connective tissue disease has overlapping features of SLE, scleroderma, and polymyositis/dermatomyositis, and is characterized by anti-U1-RNP antibodies. Systemic lupus erythematosus has a different constellation of symptoms and autoantibodies.