Elastic fibres in patients with systemic sclerosis. A morphological study.

Dermal elastic fibres in biopsies taken from sun-exposed involved digital skin and sun-protected uninvolved skin on the medial aspect of the upper arms from 13 patients with systemic sclerosis were examined by light and transmission electron microscopy. For controls, biopsies were taken from similar sites from 4 age- and sex-matched healthy volunteers and 4 patients with primary Raynaud's phenomenon. On light microscopy only the control digital biopsies showed mild actinic changes of the elastic fibres whereas in all the biopsies from patients with systemic sclerosis identical changes of thickening, clumping and fragmentation of the elastic fibres were observed. Quantitative assessment of the dermal elastic fibres using microdensitometry and video image analysis showed no significant difference between the patients and controls. On electron microscopy more advanced abnormalities similar to those seen in actinic damage and chronological aging were found in the biopsies from all the patients with systemic sclerosis compared to the controls.