In practice, the classification of scleroderma is less problematic than that of most other connective tissue diseases given the distinctive pattern of skin involvement. Classification of early and limited disease is more problematic and is difficult to separate from severe forms of Raynaud's phenomenon. Division of scleroderma into two groups depending on the presence or absence, early in the disease, of truncal skin involvement makes biological and clinical sense. Measurement using a clinical skin score remains the best approach to monitoring disease progress.