histopathological cutaneous alterations in systemic sclerosis a clinicopathological study组织病理学皮肤改变系统性硬化症临床病理的研究.pdfVIP

Van Praet et al. Arthritis Research Therapy 2011, 13:R35 /content/13/1/R35 RESEARCH ARTICLE Open Access Histopathological cutaneous alterations in systemic sclerosis: a clinicopathological study 1*† 1† 2,3† 1 1 1 Jens T Van Praet , Vanessa Smith , Marc Haspeslagh , Nele Degryse , Dirk Elewaut and Filip De Keyser 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 i