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Related Experiment Videos

Cutaneous hypoxia in patients with systemic sclerosis (scleroderma).

J L Silverstein1, V D Steen, T A Medsger

  • 1Department of Dermatology, University of Pittsburgh School of Medicine.

Archives of Dermatology
|September 1, 1988
PubMed
Summary

Systemic sclerosis (SS) patients exhibit cutaneous hypoxia in thickened skin, as measured by transcutaneous oxygen pressure (TCPO2). Oxygen administration normalized these readings, suggesting TCPO2 can assess skin thickness and hypoxia in SS.

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Area of Science:

  • Dermatology
  • Medical Physiology
  • Oxygen Transport

Background:

  • Transcutaneous oxygen pressure (TCPO2) measures skin oxygenation and is vital for assessing cutaneous hypoxia.
  • Fibroblast activity, crucial for tissue repair and fibrosis, is modulated by oxygen levels.
  • Systemic sclerosis (SS) is characterized by skin thickening and fibrosis, raising questions about underlying oxygenation status.

Purpose of the Study:

  • To investigate the presence and extent of cutaneous hypoxia in patients with systemic sclerosis (SS).
  • To determine the relationship between skin thickness and TCPO2 levels in SS patients.
  • To evaluate the potential of TCPO2 measurements as an objective tool for assessing skin involvement in SS.

Main Methods:

  • TCPO2 measurements were performed on the dorsal forearm skin of 33 SS patients and 16 controls (normal and Raynaud's disease patients).

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  • Skin thickness was clinically graded (mild, moderate, severe).
  • Measurements were taken under room air and supplemental oxygen conditions (31% O2) with a sensor at 44°C to ensure maximal vasodilation.

    • Main Results:

    • Sclerodermatous skin in SS patients demonstrated significantly lower TCPO2 values compared to uninvolved skin or controls, indicating hypoxia.
    • A significant inverse correlation was observed between skin thickness and TCPO2 levels; severely thickened skin had the lowest oxygenation.
    • Supplemental oxygen administration effectively increased TCPO2 readings in SS patients, normalizing them to control levels.

    Conclusions:

    • The thickened skin in systemic sclerosis is hypoxic.
    • TCPO2 measurement is a valuable, noninvasive method for objectively assessing skin thickness and hypoxia in SS.
    • The demonstrated cutaneous hypoxia in SS may influence fibroblast proliferation and synthetic activity, contributing to disease pathogenesis.