I consider patients for referral who have early diffuse disease who have continued to progress despite standard of care therapies. I think some would argue that this may also be appropriate for early patients as first line therapy if they have high risk features for progression, but I typically will...

HSCT referrals are appropriate for patients with rapidly evolving skin scores despite standard of care therapies. Cardiac involvement is an exclusion. Transplant should only be performed at expert centers that treat SSc patients. The specific inclusion criteria for the SCOT trial and outcomes can be...