This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Autoimmune Skin Disorders, Subject name: Skin
Which of the following is false about scleroderma? 
Select and explain. 
A. Digital ulceration, B. Gastroesophageal Reflux Disease (GERD), C. Mask like facies, D. Female preponderance of 9 :1
D: Female preponderance of 9 :1
Answer: D: Female preponderance of 9 :1 
Explanation: Ans. D. Female preponderance of 9:1Scleroderma or Systemic Sclerosis is an autoimmune rheumatic disease in which there is a 4:1 female predominance. A wide spectrum of clinical features are seen in Scleroderma:* Severe pruritus* Initially, scleroderma patients experience puffiness and non-pitting edema of fingers.* The skin later becomes indurated, thickened, and fixed to underlying structures resulting in sclerodactyly.* Vasospasm and Digital ulceration* Around 90% of patients suffering from scleroderma, have dysphagia, and GERD at the level of esophagus.* Mask like facies is seen due to the waxy nature of skin and lack of wrinkles.Typical facial features: note the expressionless facies, mat-like telangiectases, microstomia, perioral furrowing and beak-like nose.Digital UlcerationAdvanced-stage sclerodactyly with contractures and vasculopathic ulcers over the bony prominences