4th August 2020

A 39-year-old female presents with a well-defined, extremely painful ischaemic lesion

A 39-year-old female presents with a well-defined, extremely painful ischaemic lesion at the tip of her third digit on her right hand. It contains necrotic tissue. On further inspection her fingers are cold, pale and are noticeably spindle-shaped. She also complains that she has to drink liquids in order to swallow her food. An autoantibody test reveals she is anticentromere positive. 

For the patient above, please select the SINGLE most likely underlying diagnosis. Select ONE option from the list above.