“…The only positive finding was a slightly elevated centromere B antibody, which may be present in 27% systemic sclerosis, 66% CREST syndrome, 3%-12% systemic lupus erythematosus, 7% mixed connective tissue disease, and <2% Sjogren's syndrome, polymyositis, and normal blood donors. Certain groups chose to expand this work-up to offer testing for immunoglobulins, growth hormone, insulin growth factor-1, insulin, insulin resistance index, hepatitis, HIV, syphilis, karyotype, plain radiographs, and brain MRI [10]. On histopathological examination, there is a range from normal findings of the epidermal and dermal structures, to the appearance of increased collagenization with hypertrophy or hyperplasia of the surrounding adnexa [1].…”