Infection or autoimmunity? The clinical challenge of interstitial lung disease in systemic sclerosis during the COVID-19 pandemic

The novel coronavirus disease 2019 (COVID-19) pandemic is a world emergency that may inevitably complicate the clinical scenario of interstitial lung disease (ILD) secondary to systemic sclerosis (SSc). The striking similarities in computed tomography (CT) between the 2 diseases make it difficult to distinguish a worsening of SSc-ILD from a COVID-19 superinfection. For this reason, we present a case of a 67-year-old woman affected by limited cutaneous SSc with anticentromere antibody positivity, characterized by Raynaud phenomenon for 10 years, and skin involvement but no ILD or pulmonary hypertension. She was treated with symptomatic drugs but no immunosuppressive therapy. According to national and local regulations, approval by the ethics committee is not required for a case report. Weobtained the patient’s informed consent to publish the material.