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Open Access Research article

Histometric data obtained by in vivo confocal laser scanning microscopy in patients with systemic sclerosis

Kirsten Sauermann12*, Thilo Gambichler1, Sören Jaspers2, Michael Radenhausen1, Solveig Rapp1, Susanne Reich1, Peter Altmeyer1, Sven Clemann1, Stefan Teichmann2, Joachim Ennen2 and Klaus Hoffmann1

Author Affiliations

1 Department of Dermatology, Ruhr-University Bochum, Gudrunstrasse 56, D-44791 Bochum, Germany

2 Research & Development Cosmed, Beiersdorf AG, KST 4223, Unnastrasse 48, Hamburg, Germany

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BMC Dermatology 2002, 2:8  doi:10.1186/1471-5945-2-8

Published: 6 August 2002

Abstract

Background

It would be a benefit if time-saving, non-invasive methods could give hints for diagnosing systemic sclerosis. To investigate the skin of patients with systemic sclerosis using confocal laser scanning microscopy in vivo and to develop histometric parameters to describe characteristic cutaneous changes of systemic sclerosis observed by this new technique, we conducted an exploratory study.

Materials and Methods

Fifteen patients with systemic sclerosis treated with extracorporal photopheresis were compared with 15 healthy volunteers and 10 patients with other disorders also treated with extracorporal photopheresis. All subjects were investigated using confocal laser scanning microscopy in vivo.

Results

Micromorphologic characteristics of skin of patients with systemic sclerosis and measuring parameters for melanisation, epidermal hypotrophy, and fibrosis for dislocation of capillaries by collagen deposits in the papillary dermis were evaluated. An interesting finding was an increased thickness of the tissue in the dermal papillae superior to the first dermal papilla vessel. It was also possible to reproduce characteristic histologic features by confocal laser scanning microscopy in vivo. Histometric parameters for fibrosis and vascular features developed in this study showed significant differences in patients with systemic sclerosis compared to controls.

Conclusions

Although the predominant histopathological features in systemic sclerosis are findings of the reticular dermis and the subcutis, and in histopathological investigation the epidermis seems to remain unaffected by the disease, we have demonstrate some characteristic differences in the epidermis and papillary dermis by confocal laser scanning microscopy in vivo. Some of them have not been described so far. However, to use this technique as a tool for diagnosis and/or staging of systemic sclerosis, further studies are needed investigating the sensitivity and specificity of the histometric parameters developed in this study.