Skip Navigation



Rheumatology Advance Access published online on February 22, 2005
Rheumatology, doi:10.1093/rheumatology/keh559
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
44/5/607    most recent
keh559v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Ibba Manneschi, L.
Right arrow Articles by Matucci Cerinic, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ibba Manneschi, L.
Right arrow Articles by Matucci Cerinic, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© British Society for Rheumatology 2005; all rights reserved
Received September 13, 2004
Accepted January 5, 2005

Original Papers

Damage of cutaneous peripheral nervous system evolves differently according to the disease phase and subset of systemic sclerosis

L. Ibba Manneschi 1*, A. Del Rosso 2, A. F. Milia 2, A. Tani 1, D. Nosi 1, A. Pignone 2, S. Generini 2, R. Giacomelli 3, and M. Matucci Cerinic 2

1 Department of Anatomy, Histology and Forensic Medicine, University of Florence, Florence, Italy
2 Department of Internal Medicine, Section of Rheumatology, University of Florence, Florence, Italy
3 Department of Internal Medicine, University of L'Aquila, L'Aquila, Italy

* To whom correspondence should be addressed.
L. Ibba Manneschi, E-mail: ibba{at}unifi.it


  Abstract

Objective. Evidence shows that peripheral nervous system (PNS) is involved in systemic sclerosis (SSc), but few morphological studies have assessed the ultrastructural pathological modifications. The aim was to study ultrastructural modifications of skin PNS fibres in SSc according to subsets [limited SSc (lSSc) and diffuse SSc (dSSc)] and phases (early and advanced) of the disease.

Methods. Skin biopsies were taken from the forearms of 23 SSc patients (11 lSSc and 12 dSSc) and 10 controls. Each biopsy was processed for transmission electron microscopy (TEM).

Results. At TEM, observation in skin from early lSSc, signs of inflammation were evident, while PNS fibres were not damaged. The microvascular wall showed hypertrophic endothelial cells bulging into the lumen. In advanced lSSc, fibrosis prevailed on inflammation and slight ultrastructural alterations of PNS fibres were evident in the papillary derma. In early dSSc, ultrastructural alterations of PNS fibres, similar to those observed in the advanced phase of lSSc, were found together with signs of inflammation and fibrosis. In advanced dSSc, in the papillary and reticular dermis PNS fibres were reduced and showed relevant ultrastructural alterations.

Conclusions. In SSc, PNS ultrastructure damage is linked to the progression and severity of skin involvement. The alterations evolve from the early to the advanced phase mainly in the diffuse subset. In particular, the severe PNS lesions found in advanced lSSc are already present and widely diffuse in early dSSc and the microvascular involvement in early lSSc seems to precede the modification of the PNS in the skin. Thus, an early therapeutic approach can be useful to reduce the progression of PNS and skin damage in SSc patients.

Keywords: Systemic sclerosis; Peripheral nervous system; Transmission electron microscopy; Skin.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.