The Effect of High Dose Methylprednisolone on Nailfold in Early Systemic Sclerosis ( SSc )

Inclusion Criteria: * Written informed consent * Age over 18 years * Fulfilling VEDOSS criteria (9): * Raynauds' Phenomenon and * Positive for disease specific auto antibodies (anti-centromere or anti-topoisomerase antibodies) and * typical nail fold capillaroscopic findings * Puffy fingers \< 3 years * Modified Rodnan skin score = 0 Exclusion Criteria: * Presence of acroosclerosis, acrosteolysis and digital ulcers * Presence of anti-RNA polymerase III auto antibodies Previous systemic treatment for SSc, namely: * methotrexate, * prednisone (\> 14 days in previous 6 months), * mofetil mycophenolate * cyclophosphamide. Clinically significant internal organ involvement: * diffusion capacity of lung for carbon monoxide (DLCO) \< 80% predicted, * vital capacity (VC) \< 70% predicted * renal dysfunction with glomerular filtration rate (GFR) \< 60 ml/min * diastolic dysfunction \> grade 1 on echocardiography * pulmonary hypertension * weight loss \>10% in the last 6 months with unknown cause Contra-indications for methylprednisolone, such as: * pregnancy, lactation * psychotic or depressive disorder * ulcus duodeni or ventriculi * untreated hypertension (\> 160-90 mmHg) * acute infections