American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common extracutaneous feature associated with SSc?

1. Psoriasis

2. Asthma

3. Dysphagia

4. Hypertension

The correct answer is: Dysphagia

Systemic sclerosis (SSc), also known as scleroderma, is a complex autoimmune disease that is characterized by skin thickening and fibrosis, but it can also have a variety of extracutaneous manifestations. One common extracutaneous feature associated with systemic sclerosis is dysphagia, which refers to difficulty swallowing. This symptom arises due to involvement of the esophagus, which can become fibrotic in patients with SSc. The esophageal smooth muscle can be affected, leading to decreased peristalsis and resulting in dysmotility. As a result, patients may experience sensations of food getting stuck or have difficulties during the swallowing process. The other options, while they may be associated with other conditions or could occur in patients with diverse health issues, are not specific or particularly common features of SSc. Psoriasis is primarily a skin condition, asthma is a respiratory issue, and hypertension can occur due to various reasons but is not a characteristic feature of SSc itself. Therefore, dysphagia stands out as a notable extracutaneous symptom indicative of the disease's impact beyond the skin.