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CREST syndrome is a variant of scleroderma and comprises calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasis.

The cutaneous manifestations in CREST syndrome are predominantly distal to the metacarpophalangeal joints. The dorsum of the hands and perioral region may sometimes be involved. Note the sausage shaped fingers with tightly stretched skin and telangiectasia.

The most common presentation consists of Raynaud's phenomenon and telangiectases on fingers, hands, face, tongue and mucus membranes. Severe esophageal dysmotility is usually present.

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