Musculoskeletal and Rheumatologic — Connective tissue disease

A 26-year-old university student presents to you with complaint of swelling, redness and occasional pain in her hands and toes. The symptoms are more prominent when she is exposed to the cold while waiting for the bus during her morning commute. On examination, her fingers show episodic well-demarcated color change, cycling from pallor (white) to cyanosis (blue) and then to erythema (red) as they rewarm, with no ulceration, digital pitting, skin thickening, or signs of connective tissue disease.