Abatacept is a first-generation recombinant cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) immunoglobulin that acts as a T cell costimulation blocker, having the power to inhibit T lymphocyte activation, which was proved to be a significantly effective treatment in adults with localized scleroderma [28]. This evidence concerns the gene CTLA4 and localized scleroderma.