Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Feb 28;13(1):R35.
doi: 10.1186/ar3267.

Histopathological cutaneous alterations in systemic sclerosis: a clinicopathological study

Jens T Van Praet  1 , Vanessa Smith, Marc Haspeslagh, Nele Degryse, Dirk Elewaut, Filip De Keyser
Affiliations

Histopathological cutaneous alterations in systemic sclerosis: a clinicopathological study

Jens T Van Praet et al. Arthritis Res Ther. .

Abstract

Introduction: The aims of the present study were to identify histopathological parameters which are linked to local clinical skin disease at two distinct anatomical sites in systemic sclerosis (SSc) patients with skin involvement (limited cutaneous systemic sclerosis (lcSSc) or diffuse cutaneous systemic sclerosis (dcSSc)) and to determine the sensitivity of SSc specific histological alterations, focusing on SSc patients without clinical skin involvement (limited SSc (lSSc)).

Methods: Histopathological alterations were systematically scored in skin biopsies of 53 consecutive SSc patients (dorsal forearm and upper inner arm) and 18 controls (upper inner arm). Clinical skin involvement was evaluated using the modified Rodnan skin score. In patients with lcSSc or dcSSc, associations of histopathological parameters with local clinical skin involvement were determined by generalised estimation equation modelling.

Results: The hyalinised collagen score, the myofibroblast score, the mean epidermal thickness, the mononuclear cellular infiltration and the frequency of focal exocytosis differed significantly between biopsies with and without local clinical skin involvement. Except for mononuclear cellular infiltration, all of the continuous parameters correlated with the local clinical skin score at the dorsal forearm. Parakeratosis, myofibroblasts and intima proliferation were present in a minority of the SSc biopsies, but not in controls. No differences were found between lSSc and controls.

Conclusions: Several histopathological parameters are linked to local clinical skin disease. SSc-specific histological alterations have a low diagnostic sensitivity.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Histopathological alterations in the skin of SSc patients. All photographs were taken at ×200 magnification. (A) Entrapment of an eccrine sweat gland. (B) Focal exocytosis (arrow). (C) Intima proliferation in a deep arteriole. (D) Parakeratosis (arrow). (E) Pigment incontinence (arrow). (F) Telangiectasia. (A and C-F) Haematoxylin and eosin staining. (B) Anti-CD3 staining.
See this image and copyright information in PMC

References

    1. Denton CP, Black CM, Abraham DJ. Mechanisms and consequences of fibrosis in systemic sclerosis. Nat Clin Pract Rheumatol. 2006;2:134–144. doi: 10.1038/ncprheum0115. - DOI - PubMed
    1. Akesson A, Fiori G, Krieg T, van den Hoogen FH, Seibold JR. Assessment of skin, joint, tendon and muscle involvement. Clin Exp Rheumatol. 2003;21:S5–S8. - PubMed
    1. LeRoy EC, Medsger TA Jr. Criteria for the classification of early systemic sclerosis. J Rheumatol. 2001;28:1573–1576. - PubMed
    1. Koenig M, Joyal F, Fritzler MJ, Roussin A, Abrahamowicz M, Boire G, Goulet JR, Rich E, Grodzicky T, Raymond Y, Senécal JL. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud's phenomenon to systemic sclerosis: a twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum. 2008;58:3902–3912. doi: 10.1002/art.24038. - DOI - PubMed
    1. Smith V, Van Praet JT, Vandooren B, Van der Cruyssen B, Naeyaert JM, Decuman S, Elewaut D, De Keyser F. Rituximab in diffuse cutaneous systemic sclerosis: an open-label clinical and histopathological study. Ann Rheum Dis. 2010;69:193–197. doi: 10.1136/ard.2008.095463. - DOI - PubMed

Publication types