THE TREATMENT of patients with diffuse cutaneous systemic sclerosis (SSc) remains
unsatisfactory. Although the pathogenesis of this highly complex disease involves vascular
injury and cellular and humoral autoimmunity, it is the progressive fibrosis affecting the skin
and multiple organs that ultimately accounts for the most striking clinical features of the
disease and is responsible for much of the associated morbidity and mortality. Attempts to
treat fibrosis with empirically based therapies, such as penicillamine, colchicine, and …