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Pathological changes observed in the finger biopsy of patients with vibration-induced white finger
Abstract:
Lesion biopsies of 60 fingers from 30 patients with vibration-induced white finger (VWF) and control observations from seven fingers of five referents demonstrated three main characteristic pathological changes. First, in each case, the muscular layers of the arteries revealed intense thickening with strong hypertrophy of individual muscle cells without intimal fibrosis. Periarterial fibrosis was also noted. Arteriosclerosis with foamy cells, lipid deposition, and fibrous sclerosis was occasionally observed. The second main change was demyelinating neuropathy in the peripheral nerves in which a marked loss of nerve fibers had occurred. There was also an increase in the number of Schwann cells and fibroblasts with strong collagen formation. Severe loss of myelin sheath frequently occurred, and relatively smaller axons without myelin which appeared to have regenerated were observed. Perineural fibrosis was also noted. In the third main pathological change connective tissues with collagen were increased not only in the perivascular and perineural lesions, but also abundantly in the corium of the skin. The elastic fibers there had been destroyed. These three principal pathological changes are very useful for the histopathological diagnosis of VWF.
Insights
Histopathological examination of vibration-induced white finger (VWF) revealed three key changes: arterial wall thickening, peripheral nerve demyelination, and increased collagen in skin connective tissues. These findings aid in diagnosing VWF.
Area of Science:
- Pathology
- Occupational Medicine
- Neurology
Background:
- Vibration-induced white finger (VWF) is a condition affecting workers exposed to vibrating tools.
- Understanding the underlying pathology is crucial for accurate diagnosis and management.
Purpose of the Study:
- To identify and describe the characteristic histopathological changes in fingers affected by VWF.
- To assess the utility of these changes for diagnostic purposes.
Main Methods:
- Biopsies from 60 fingers of 30 VWF patients and control samples from 5 individuals were analyzed.
- Histopathological examination focused on arterial, neural, and dermal connective tissues.
Main Results:
- Arteries showed significant thickening of muscular layers with muscle cell hypertrophy and periarterial fibrosis.
- Peripheral nerves exhibited demyelinating neuropathy with nerve fiber loss, increased Schwann cells, and perineural fibrosis.
- Skin connective tissues displayed increased collagen, destruction of elastic fibers, and perivascular/perineural lesions.
Conclusions:
- The study identified three principal pathological changes in VWF: arterial wall changes, peripheral nerve damage, and dermal connective tissue alterations.
- These histopathological findings are valuable for the diagnosis of vibration-induced white finger.