This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
Diffuse cutaneous systemic sclerosis is characterised by: 
Select and explain. 
A. Early pulmonary fibrosis, B. Raynauds phenomenon, C. Calcinosis cutis, D. Long term prognosis is better
A: Early pulmonary fibrosis
Answer: A: Early pulmonary fibrosis 
Explanation: Diffuse cutaneous SSc is associated with 1. Progressive skin induration 2. Early pulmonary fibrosis and acute renal involvement. Limited cutaneous SSc have 1. Long-standing Raynaud's phenomenon before other manifestations of SSc appear. 2. Skin involvement remains limited to the fingers (sclerodactyly) A subset of patients with limited systemic sclerosis have a) calcinosis cutis, b) Raynaud's phenomenon, c) esophageal dysmotility, d) sclerodactyly e) telangiectasia (Termed CREST syndrome) Long term prognosis is poor in diffuse variety than limited systemic sclerosis. Ref: Harrison, E-18, P- 2757.