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Ultrastructural changes of cutaneous nerves in scleroderma.
1Department of Pathology, University of Medicine, Plovdiv, Bulgaria.
Folia Medica
|January 1, 1992
Summary
Scleroderma causes significant ultrastructural damage to cutaneous nerves, affecting both myelinated and unmyelinated fibers. These nerve changes may underlie the development of neuropathy in patients.
Area of Science:
- Dermatology
- Neurology
- Pathology
Background:
- Scleroderma is a complex autoimmune disease characterized by fibrosis and vascular abnormalities.
- Cutaneous nerve involvement in scleroderma can lead to sensory disturbances and pain.
Purpose of the Study:
- To investigate the ultrastructural changes in cutaneous nerves of patients with progressive and circumscribed scleroderma.
- To correlate these nerve alterations with potential neuropathic complications.
Main Methods:
- Electron microscopy was used to examine nerve biopsies from 38 patients with progressive scleroderma and 8 with circumscribed scleroderma.
- Detailed analysis of myelinated and unmyelinated nerve fibers, Schwann cells, and surrounding connective tissue.
Main Results:
- All patients showed significant changes in both myelinated and unmyelinated nerve fibers.
- Observed alterations included myelin sheath disintegration, Schwann cell edema, basal membrane thickening, and axis cylinder changes.
- Nerve fibers were frequently surrounded by collagen fibrils, suggesting a fibrotic microenvironment.
Conclusions:
- Ultrastructural nerve damage is a consistent finding in scleroderma, impacting peripheral nerve integrity.
- These observed nerve alterations provide a morphologic basis for the neuropathy that often develops in scleroderma patients.