Changes in endothelial cell mass, luminal volume and capillary number in the gravitational syndrome

The histopathological changes in the skin of 31 patients with the gravitational syndrome and 10 normal control subjects were studied. To quantify the clinical severity of the syndrome, a new index of severity was used. Histometric evaluation of the cutaneous vasculature was performed on biopsies taken from the edge of the ulcers in the 31 patients and from the medical aspect of the lower legs in control subjects. Endothelial cell mass did not correlate with the clinical index of disease severity, suggesting that angiogenesis did not necessarily signal healing. The mean luminal volume appeared to be of greater prognostic value as there was a significant negative correlation of this parameter with the index of clinical severity. The degree of epidermal hyperplasia was found to be related to both the amount of inflammatory cell infiltrate present and the endothelial cell mass per unit tissue volume. The results also showed that the clinical index of disease severity was positively correlated to the mean epidermal thickness. The quantitative evaluation of biopsy material can be used to provide prognostic information in the gravitational syndrome.