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Introduction Very early diagnosis of Systemic Sclerosis (SSc) is difficult because there are no typical symptoms of the disease. The diagnosis of very early SSc was established in the presence of edema of the hands, Raynaud’s phenomenon (RH), positive ANF, capillaroscopic changes and the duration of the disease is not more than 36 months from the appearance of the first non-Raynaud’s syndrome.Material and Methods During 3 years of follow-up, 36 out of 900 pts with SSc had early SSc, of which 31 were women, aged 19 to 85 years (average 46.8+-16.98), disease duration of 5 [1; 8] mth. 24 pts with SSc met 2013 ACR/EULAR criteria despite short disease duration, 12 pts - the criteria for very early SSc/VEDOSS 2011, with 2 of 4 signs, 75% pts had 3 characteristic manifestations.Results The duration of RH was 12.5 [8.8; 24.5] mth, 67% pts developed it within 18 mth prior to the date of presentation. 83% pts had persistent swelling of the fingers, which lasted an average of 6.9±5 mth before they consulted a rheumatologist. The visceral pathology was predominantly gastrointestinal, and 58% pts had esophageal hypotension.Despite the short duration of the disease, 14% pts had initial signs of interstitial lung disease, with parenchyma lesions of less than 20% according to high–resolution computed tomography. FVC was 100% [92;110], DLCO was 70.2% [64.6; 80]. 2 pts had a pronounced decrease in DLCO to 35% and 26% with a disease duration of 16 and 3 mth, respectively. Indirect signs of increased pressure in the pulmonary artery of SDLP more than 40 mm Hg were detected in 9% pts and amounted to 40, 41 and 49 mm Hg. Visceral pathology reflected the speed of disease progression. All pts were ANA positive, ACA - in 36%, anti-Scl-70 -in 14%, a-RNP - in 11%, a-Ro in 8% and a-PmScl in 5.5% pts. All pts had pattern of early inactive scleroderma-type changes, 8%pts had a combination of scleroderma and myopathic variants of capillaroscopic changes.There was a correlation of FVC with puffy fingers and a-Scl 70 (p<0.4 and p<0.4, respectively, and an inverse correlation between DLCO and pericarditis (p<-0.6).Conclusions The presence of damage to internal organs indicates the need for early diagnosis and active therapy to prevent disease progression