In systemic sclerosis (SSc), widespread skin and visceral fibrosis are associated with poor outcome and increased mortality [1]. For this reason, SSc management remains a challenge due to clinical heterogeneity and the presence of comorbidities that can complicate the clinical picture, impacting on patients’ outcomes and survival [2]. The term comorbidity has a Latin origin: “co morbus” meaning “along with the disease”. Although the first definition of this topic in 1970 referred to “any distinct additional clinical entity that has existed or that may occur during the clinical course of a disease that is under study” [3], it is now well known that a comorbidity has the potential role to impact patient's prognosis, and also to modify therapeutic plans and outcomes [4–6].
