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This study assessed skin symptoms in 126 SSc patients from a dermatological hospital Italy, using the items from the Skindex-29 for all symptoms and psychosocial variables. Multivariate logistic regression and attributable risk among the exposed (ARexp) were used for analysis. Pain (74.0%), burning (62.1%), and water irritation (52.4%) were the most reported symptoms. Older patients (\u226558\u2009years; mean age\u2009=\u200958.7, SD\u2009=\u200912.01) and those with severe disease reported higher symptom frequencies. Water irritation strongly predicted shame (OR 21.3) and frustration (OR 5.8), with ARexp indicating that alleviating water-related discomfort could reduce shame by 95.3%, frustration by 82.8%, and tiredness by 92.1%. Pain and itch were linked to depression and sleep loss. 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