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Illustration 1. The patient, a 63-year-old man with a 35-year history of limited cutaneous systemic sclerosis (SSc), had telangiectases affecting the hands and face (a) and (b), a common clinical feature of SSc. SSc-related telangiectases reflect the distortion of the microvascular architecture, which is characteristic of well-established disease. As was demonstrated with this patient, microvascular pathology can be well visualized by dermoscopy (c) (original magnification × 10), which showed the arborized nature of the abnormal microvessels, and by nailfold videocapillaroscopy (d) (original magnification × 300), which showed dilated, distorted capillaries (left side of the image). The vascular nature of this patient's disease was also characterized by severe Raynaud's phenomenon and pulmonary arterial hypertension.

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