Macrophage migration inhibitory factor (MIF) is a pleiotropic inflammatory molecule with a broad range of immunomodulatory properties.3 MIF has been shown to play a role in disease progression of autoimmune and inflammatory disorders, including rheumatoid arthritis, systemic lupus erythematosus (SLE), inflammatory bowel disease and multiple sclerosis.3, 4, 5 Studies have suggested possible associations between MIF and SSc, but the relationship between the two is unclear. This evidence concerns the gene MIF and systemic sclerosis.