Vascular alterations in human and avian SSc predominantly affect the microvasculature with intimal proliferation, occlusion of blood vessel and capillary necrosis, leading to a decreased blood flow, a state of chronic ischaemia and clinical manifestations such as fingertip ulcers and comb lesions.5, 6 Tissue hypoxia normally induces neoangiogenesis, but in SSc vascular repair and angiogenesis seem to be strongly disturbed.7–9 One of the key molecules in the induction of angiogenesis is vascular endothelial growth factor (VEGF). The gene discussed is VEGFA; the disease is systemic sclerosis.