Morphologic and histochemical changes in the skin of patients with scleroderma.

BACKGROUND: Systemic sclerosis or scleroderma is a rare collagen disease, characterized by insufficient angiogenesis. Few data are available about the morphologic and histochemical peculiarities of the skin in these patients with this condition. The purpose of the present work was to evaluate the histochemical aspects of sclerodermic skin, obtained through biopsy of the typical lesions from the forearm skin. PATIENTS AND METHODS: The study was conducted on 31 patients, from which skin biopsies were obtained, after informed consent. The specimens were fixed in buffer formalin, embedded in paraffin and processed for staining with HE, Masson, orcein, Gordon-Sweet silver staining, and alcian blue-safranin, in order to identify elastic fibers, reticular fibers, glycosaminoglycans and mast cells. Results are partially similar to other studies: the constant depletion of elastic fibers in the papillary dermis and disorders of the network in the reticular dermis, such as their absence in the skin blood vessels walls. The reticular fibers were absent in the papillary dermis, the reaction in the reticular dermis structure was variable from a case to another. The staining with Alcian blue-Safranin proved that there is a gathering of glycosaminoglycans in the superficial papillary dermis, the heterogeneity of collagen fibers and the decrease of mast cells in the dermis.