We observed an indirect impact of R. mucilaginosa (dry skin) on local scleroderma through CD33dim HLA DR+ CD11b+ Myeloid cell, with a mediated proportion of 5.86% (95% CI = 0.207–11.5%, p  =  0.0422) of the total effect (Figure 8B). Here, ITGAM is linked to scleroderma.