Since the last issue of Rheumatic Disease Clinics of North America on systemic sclerosis (SSc, scleroderma), there have been great advances in our understanding of the pathogenesis of this disease with the identification of multiple potentially promising targets for therapy. Remarkable progress has been made in determining genetic susceptibility factors and the different gene expression patterns that characterize disease tissue, which are summarized in the article entitled, “Genetics, Epigenetics, and Genomics of Systemic Sclerosis.”
The article by Stern and Denton provides an elegant summary of current thought on SSc pathogenesis and the interplay of immune dysfunction, endothelial damage, and fibrotic pathways that contribute to disease. The article by Pope and Johnson presents the new 2013 classification system that more completely captures SSc patients, particularly those with early disease, for whom intervention may be more effective. Relevant case studies are provided to demonstrate how the new criteria can be applied to real world cases. The next seven articles discuss the major organ system manifestations with a focus on therapeutic options.
New in this issue, and of great importance to our patients, is a discussion of the psychosocial elements of SSc (“Psychosocial Aspects of Scleroderma”), and the burden these impose on our patients, including depression, anxiety, fatigue, sleep disruption, pain, pruritus, body image dissatisfaction, and sexual dysfunction.
These articles are meant to provide the interested clinician and researcher with the most current understanding of this complex and fascinating disease.
Contributors include scleroderma experts from the United States, Canada, the United Kingdom, Australia, and Europe reflecting the collaborative international effort for improved understanding and management of this disease. I am indebted to my colleagues for their dedication, expertise, and timely submissions. It is an honor to be part of this company.