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Therefore, early diagnosis and early treatment is most important for the treatment of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c. We established diagnostic criteria for <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c in 2003 and early diagnostic criteria for <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c in 2011, for the purpose of developing evaluation of each organ in <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c. Moreover, in November 2013, the American College of Rheumatology and the European Rheumatology Association jointly developed new diagnostic criteria for increasing their sensitivity and specificity, so we revised our diagnostic criteria and severity classification of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c. Furthermore, we have revised the clinical guideline based on the newest evidence. In particular, the clinical guideline was established by clinical questions based on evidence\u2010based medicine according to the New Minds Clinical Practice Guideline Creation Manual (version 1.0). We aimed to make the guideline easy to use and reliable based on the newest evidence, and to present guidance as specific as possible for various clinical problems in treatment of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c.<\/jats:p>","DOI":"10.1111\/1346-8138.14162","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T06:21:06Z","timestamp":1524550866000},"page":"633-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Diagnostic criteria, severity classification and guidelines of systemic sclerosis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5560-9778","authenticated-orcid":false,"given":"Yoshihide","family":"Asano","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine The University of Tokyo Tokyo 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