State-of-the-art technologies provide new insights linking skin and blood vessel abnormalities in SSc-related disorders.

•State-of-the-art non-invasive imaging methods provide new insights into the pathophysiology of SSc-spectrum disorders.•In ‘SSc fingers’, perfusion correlates positively with oxygenation, and capillary density negatively with skin thickness.•This study further confirms that fibrosis and microvascular changes are key elements of the SSc disease process.