In systemic sclerosis macrovascular damage of hands digital arteries correlates with microvascular damage

► Distal peripheral artery disease is present in the digits of systemic sclerosis patients. ► Ultrasonography damage of proper palmar digital arteries appears in late stages of microangiopathy. ► Blood flow dysfunction of digital arteries is already present in early disease. ► Macrovascular damage progresses with worsening of systemic sclerosis microangiopathy.