A Clinicomorphological Study of Scleroderma and Morphea

Abstract

Introduction: Cutaneous involvement is a prominent feature in connective tissue disease and the skin lesions are extremely important in diagnosing and subclassifying patients with these conditions. Scleroderma (Systemic sclerosis) and Morphea (Localized Scleroderma) are two common clinical conditions with skin involvement include in connective tissue diseases of skin. Scleroderma is usually a progressive and frequently fatal disease of unknown etiology. In Morphea (Localized scleroderma) the lesions usually are limited to the skin and to the subcutaneous tissue beneath the cutaneous lesions. Although their evolutions are divergent, they share similar histologic features.

Objectives: 1.To study various histological features in cutaneous lesions of systemic scleroderma and morphea. 2. To analyze overlapping features, possible transformation of one disease to the other and co-existence in this group of diseases.

Methods: Clinically established / suspected cases of cutaneous lesions of systemic scleroderma and morphea were biopsied. After routine processing and paraffin embedding of formalin fixed tissue Haematoxyline and Eosin (H&E) sections were studied along with special stain Verhoeff vangiesson(VVG).

Results: Cutaneous lesions of 27 cases (9 cases of scleroderma and 18 cases of morphea) were studied and analyzed. Both the conditions were common in females.

Conclusion: Though these two conditions vary in clinical manifestations, involvement of internal organs and types of autoimmunity, the cutaneous lesions share similar histologic features. Often it is necessary to use other diagnostic tools like serological and immunological study in conjunction with histopathology with the background of clinical history for a conclusive diagnosis.