What does the clinician need to improve patient care in systemic sclerosis?

S ystemic sclerosis (SSc) is a multisystemic disorder of unknown cause characterised by fibrotic and degenerative changes in skin, blood vessels and internal organs. The clinical spectrum of SSc, and hence its prognosis, is quite variable. Validated subset classification, activity and severity criteria are available. However, despite their usefulness, these criteria have several limitations. Furthermore, diagnostic criteria of SSc are lacking. To improve the care of patients with scleroderma, the clinician needs to initiate optimal, early treatment. Diagnostic criteria that aid early diagnosis as well as classification, severity criteria that aid estimation of prognosis, and disease activity criteria that indicate active disease could help the clinician in daily practice. Present international collaborations such as the EULAR Scleroderma Trial and Research Group (EUSTAR) and the North American Scleroderma Clinical Trials Consortium (SCTC) are thriving, providing the ideal circumstances for clinimetric studies of SSc. This editorial discusses the state of the art of clinimetrics in SSc and possible ways to overcome the present limitations.