ATM and interstitial lung disease: Whereas, dcSSc, which includes patients with cutaneous involvement proximal to the elbows or knees, is frequently associated with anti-topoisomerase I antibody (ATA), tendon friction rub, early internal organ involvement such as ILD, myocardial and diffuse GI tract involvement; hence, dcSSc is known to have poorer prognosis than lcSSc (12).