A 36-year-old woman was diagnosed with Ph (+) acute lymphoblastic leukemia in 2013. She was treated with HyperCVAD chemotherapy and dasatinib, with complete molecular remission after 4 months of treatment. She received a PBSCT from her HLA identical brother after a myeloablative conditioning (CY-TBI) and GVHD prophylaxis with methotrexate and cyclosporine. She developed aGVHD NIH grade 1 with intestinal involvement initially treated with budesonide. 24 months later she started with hyperpigmentation in thorax and severe and rapidly progressive sclerodermoid features in the legs, arms and neck, with deep panniculitis and fasciitis-like sclerotic cGVHD NIH grade 3. Skin biopsy confirmed cGVHD, and systemic corticosteroids and low-dose oral methotrexate were started, with only partial response after 2 months of therapy. There was no clinical improvement after 4 months with progression of her scleroderma with severe involvement of movement in the legs and hip rotation. There was no response to ECP 12 sessions. Ruxolitinib 10 mg QD was started and scleroderma improved significantly after 3 months allowing a normal deambulation. After 11 months of ruxolitinib, sclerodermic form persists but in lower grade and normalization of skin changes. Modified Rodnan score improved from 26 to 16 (Fig. 5).