When there's smoke there's…scleroderma: evidence that patients with scleroderma should stop smoking.

There is no treatment for the autoimmune disease scleroderma (systemic sclerosis, SSc), a multisystem disorder characterized by vascular damage and fibrosis. In particular, SSc can severely affect the lung, resulting in pulmonary arterial hypertension and fibrosis. Smoking is well-known to affect pulmonary health, and a recent report (Hudson et al., Arthritis Rheum, in press Oct 8) provides convincing evidence that stopping smoking improves disease outcome in SSc patients. This commentary discusses this recent publication which suggests that physicians should encourage SSc patients to stop smoking immediately.