A 36-yrs-old woman presents with increased trouble swallowing. Physical examination finds hypeension and sclerodactyly. Lab tests find Anti- Scl- 70. Which of the following biopsies is most characteristic of this disorder?: (A) A conjunctival biopsy that reveals noncaseating granulomas, (B) A peripheral nerve biopsy that reveals rare acid- fast bacteria, (C) A skin biopsy that reveals dermal fibrosis with an absence of adnexal structures, (D) A subcutaneous fat biopsy that reveals an infiltrate of plasma cells and eosinophils
Answer is C. A skin biopsy that reveals dermal fibrosis with an absence of adnexal structures * The combination of trouble swallowing, hypeension, and sclerosis of the skin should raise the possibility of progressive systemic sclerosis (scleroderma), a multisystem disease that involves the cardiovascular, * a peripheral nerve biopsy that reveals rare acid-fast bacteria is diagnostic of leprosy; and a temporal aery biopsy that reveals fragmentation of the internal elastic lamina is characteristic of ternporal aeritis.