-widespread fibrosis and degenerative changes involving many organs

-fixed facial appearance, sclerodactyly (claw-like hand), Raynaud phenomenon, visceral organs involvement (esophagus-dysphagia, lung-internsitial pulmonary fibrosis, hypertension).

-anti-Scl-70, ANAs with anticentromere activity (in CREST syndrome)

-CREST syndrome: caclinosis, raynaud phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia