In fact, although we have not investigated, we believe that the increased expression of TGF-β1, a well-known profibrotic cytokine found in the early stages of SSc, can contribute to induce the differentiation of papillary fibroblasts to a phenotype of reticular fibroblasts, which expresses increased alpha smooth muscle actin-α (α-SMA) and fibrillar type I and III collagen [23,24,25]. Here, ACTA1 is linked to systemic sclerosis.