Previous studies have shown that conditioned media from SSc keratinocytes can upregulate the expression of collagen type I (Col1A1) and α‐SMA in fibroblasts compared with that in media from healthy donors.[12] Notably, this effect can be independent of transforming growth factor‐β (TGF‐β) and accompanied by an imbalance in the nuclear factor kappa B (NF‐kB) pathway.[12] Nevertheless, the key mediators and mechanisms by which keratinocytes promote fibroblast activation remain unclear. This evidence concerns the gene ACTA1 and systemic sclerosis.