More than Skin Deep: Bringing Precision Medicine to Systemic Sclerosis

Historically, patients with systemic sclerosis (SSc) have been classified by the extent of their skin involvement - diffuse cutaneous SSc, characterized by skin involvement of the torso and proximal limbs, and limited cutaneous SSc, with involved skin predominantly distal to the elbows and knees. Subgrouping based on cutaneous type is grounded in literature demonstrating differences in organ involvement and mortality [1]. However, this binary classification system does not capture the marked clinical heterogeneity known to exist within these two subgroups. Attempting to risk-stratify a given SSc patient's clinical trajectory, organ-specific complications, and response to medications based solely on cutaneous type is an imperfect approach in the modern era.

as reported in: Arthritis Rheumatol. 2019 Nov 2 [Epub ahead of print]