Current approaches to the management of early active diffuse scleroderma skin disease.

Skin sclerosis is a clinical hallmark of systemic sclerosis (SSc) and provides a means to classify and evaluate patients. In the diffuse cutaneous subset, skin involvement is often extensive and warrants direct therapy. Currently, broad spectrum immunosuppressive strategies are used, but more targeted specific approaches are now emerging. This article reviews the evidence for efficacy of current treatment approaches and future developments for managing skin disease in early diffuse cutaneous SSc.