A 39-year-old man presents with a 6-month history of severe headaches and pain o

Question

A 39-year-old man presents with a 6-month history of severe headaches and pain of the hands upon exposure to cold. Over the past 3 months, he has noticed progressive difficulty in swallowing solid food. Physical examination reveals smooth and tight skin over the face and fingers. The serologic test for anti–Scl-70 (antitopoisomerase) is positive. Which of the following vascular changes accounts for this patient's headaches and hand pain?

Options:

A) Smooth muscle cell proliferetion and lipid deposition

B) Intimal thicking and fibrosis

C) Vasculitis and fibrinoid necrosis

D) Acute inflammation of the intima

E) Giant cell granulomatous inflammation

Explanation / Answer

The above given symptoms suggests that the person is suffering from systemic sclerosis.

In sclerosis injury to the endothelium causes thickening of intimal layer of blood vessels leading to vasoconstriction causing pain in hands on exposure to cold and headaches. Fibroblast activation leads to excessive production of collagen and fibrosis which leads to tightening of the skin

So the answer is (B) intimal thickening and fibrosis

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