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Lymphatic microangiopathy of the skin in systemic sclerosis

Leu, A J. ; Gretener, S B. ; Enderlin, S. ; Brühlmann, P. ; Michel, B A. ; Kowal-Bielecka, O. ; Hoffmann, U. ; Franzeck, U K.

In: Rheumatology (Oxford, England), 1999, vol. 38, no. 3, p. 221-227

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    Titel
    • Lymphatic microangiopathy of the skin in systemic sclerosis
    Autor
    • Leu, A J.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Gretener, S B.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Enderlin, S.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Brühlmann, P.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Michel, B A.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Kowal-Bielecka, O.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Hoffmann, U.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    • Franzeck, U K.. Department of Internal Medicine, University Hospital, Zurich, Switzerland.
    Dokumententyp
    • Postprint
    OAI-PMH-ID
    • oai:doc.rero.ch:304225
    Summary
    METHODS: The cutaneous capillary lymphatic system in patients with systemic sclerosis was investigated using fluorescence microlymphography. The distal upper limbs of 16 healthy controls (mean age 62.3+/-13.1 yr) and 16 patients with systemic sclerosis (mean age 58.9+/-13.6 yr) were examined and the following parameters were evaluated: (a) single lymphatic capillaries; (b) lymphatic capillary network and cutaneous backflow; (c) extension of the stained lymphatics; (d) diameter of single lymphatic capillaries. RESULTS: At the finger level, lymphatic capillaries were lacking in five patients, while they were present in all controls (P < 0.05). Extension of the stained lymphatics was increased in 11 patients (8.1+/-6.0 mm) compared to the 16 healthy controls (2.0+/-1.2 mm) (P < 0.0001). Cutaneous backflow was observed in three patients (P < 0.05). At the hand level, lymphatic network extension was significantly different between patients (3.8+/-2.4 mm) and controls (1.2+/-0.8 mm) (P < 0.01); however, no significant differences were found at the forearm level. CONCLUSION: Lesional skin in patients with systemic sclerosis exhibits evidence of lymphatic microangiopathy