Skin fibrosis, the hallmark feature of SSc remains without effective treatment. Although skin changes in SSc are not a cause of mortality, they cause considerable morbidity, may reflect similar pathological processes to those that occur in the bowel and lungs, correlate highly with prognosis and disease progression in other organ systems, and can be reproducibly assessed by skin score testing. Skin disease is of particular interest for evaluation in clinical trials since it is easily biopsied and can thus be repeatedly assessed for pathological changes during clinical trials (Lafyatis et al., 2009).