The patient is a 66 year old Caucasian female with a pertinent past medical history of a probable collagen vascular disease variant, likely limited scleroderma (also known as CREST Syndrome) for the past 30 years, a diagnosis recently clinically re-confirmed. Relevant clinical findings include Raynaud’s syndrome, sclerodactyly, and skin tightening of the toes and fingers. Muscle and skin biopsies have all been nonspecific showing some skin thickening, occasional lymphocytes, without specificity.