Introduction Systemic sclerosis (SSc) is an autoimmune rheumatic disease characterized by vascular damage and fibrosis of the skin and/or internal organs, with high clinical burden and unsatisfactory treatment. [1] Skin fibrosis is a clinical hallmark of the disease, [2] and an important marker of disease activity, [3] severity [4,5] and prognosis. [4,5] The extent of skin involvement and its rate of progression are associated with internal organ involvement, functional disability, and survival.
