Skin nontumor
Dermal collagen and elastic tissue alterations, and cutaneous deposits
Scleroderma
Topic Completed: 1 August 2011
Minor changes: 5 August 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Scleroderma [title] skin
Table of Contents
Definition / general | Clinical features | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Negative stains | Differential diagnosis | Additional referencesCite this page: Hamodat M. Scleroderma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorscleroderma.html. Accessed October 24th, 2020.
Definition / general
- Either localized (morphea) or systemic (involving skin of face, upper trunk, hands and arms, esophagus, heart and lungs)
- May have visceral disease without skin disease
- May be associated with Raynaud phenomenon, Borrelia burgdorferi infection
Clinical features
- Usually presents on trunk or extremities as one or several indurated plaques with ivory center and violaceous border (the lilac ring)
- Also lesions confined to breast
- May have irregular areas of hyperpigmentation or hypopigmentation
- Occasionally more than one type is present
Clinical images
Contributed by Mark R. Wick, M.D.
Breast skin, morphea
Contributed by Michael Inskip, M.B.Ch.B.
Image hosted on other servers:
Dermal sclerosis
Microscopic (histologic) description
- Thickening and hyalinization of connective tissue of deep dermis, subcutaneous fat and muscular fascia, with perivascular and focal interstitial lymphocytic and plasma cell infiltrate in subcutaneous fat
- Frequent atrophy of adnexal structures, increased fibroblasts, thickening and luminal narrowing of small vessels, blunting of dermal-subcutis interface, diminished elastic tissue
- Often atrophy of epidermis, mucin deposition
- Variable dystrophic calcification of blood vessels
- Control biopsy from adjacent normal skin is helpful
Microscopic (histologic) images
Contributed by Mark R. Wick, M.D.
Breast skin, morphea
Contributed by Joel Pinczewski, M.D., Ph.D.
Negative stains
- Immunoglobulins
Differential diagnosis
- Elastosis due to sunlight: normally on thick dermis of fingers and dorsum of hand
- Eosinophilic fasciitis: thickening of deep fascia only
- Lichen sclerosus et atrophicus, acrodermatitis chronic atrophicans
Additional references
