Rheumatology, Vol 38, 221-227, Copyright © 1999 by British Society for Rheumatology
AJ Leu, SB Gretener, S Enderlin, P Bruhlmann, BA Michel, O Kowal-Bielecka, U Hoffmann and UK Franzeck
METHODS: The cutaneous capillary lymphatic system in patients with systemic
sclerosis was investigated using fluorescence microlymphography. The distal
upper limbs of 16 healthy controls (mean age 62.3+/-13.1 yr) and 16
patients with systemic sclerosis (mean age 58.9+/-13.6 yr) were examined
and the following parameters were evaluated: (a) single lymphatic
capillaries; (b) lymphatic capillary network and cutaneous backflow; (c)
extension of the stained lymphatics; (d) diameter of single lymphatic
capillaries. RESULTS: At the finger level, lymphatic capillaries were
lacking in five patients, while they were present in all controls (P <
0.05). Extension of the stained lymphatics was increased in 11 patients
(8.1+/-6.0 mm) compared to the 16 healthy controls (2.0+/-1.2 mm) (P <
0.0001). Cutaneous backflow was observed in three patients (P < 0.05).
At the hand level, lymphatic network extension was significantly different
between patients (3.8+/-2.4 mm) and controls (1.2+/-0.8 mm) (P < 0.01);
however, no significant differences were found at the forearm level.
CONCLUSION: Lesional skin in patients with systemic sclerosis exhibits
evidence of lymphatic microangiopathy.
ORIGINAL PAPERS
Lymphatic microangiopathy of the skin in systemic sclerosis
Department of Internal Medicine, University Hospital, Zurich, Switzerland.
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