Systemic Sclerosis

Systemic sclerosis (SSc) is a complex autoimmune rheumatic disease that is characterised by widespread skin and internal organ fibrosis, immune system dysregulation, and vasculopathy. The disease carries a significant burden of pain and disability that is potentially life-limiting because of major internal organ-based complications. Early diagnosis is vital and key investigations include the detection of SSc-associated autoantibodies and nailfold capillaroscopic abnormalities. Patients should be managed by a dedicated, specialist, multidisciplinary team. There is now a range of effective treatments available for many of the complications associated with the disease. Autologous haematopoietic stem cell transplantation may benefit a small subset of patients with very poor prognosis SSc. Important advances have been made in understanding the aetiopathogenesis of SSc, which is driving clinical trials of new therapeutic approaches. The purpose of this review is to provide a clinically focussed description of the relevant aetiopathogenesis, clinical expression of disease, approach to the assessment and treatment of SSc, and highlight the recent advances and future challenges associated with this complex disease.