Fisher and Rodnan1 studied the histochemical, immunohistochemical, and electron microscopic features of skin obtained from 15 patients with progressive systemic sclerosis. Skin obtained from clinically uninvolved areas stained with hematoxylin and eosin appeared normal. Variable degrees of homogenization of dermal collagen was observed in patients with minimal involvement. Biopsies from more advanced stages of scleroderma disclosed the characteristic features of the disease, notably atrophy of rete pegs of the epidermis, homogenization of dermal collagen exhibiting a parallel arrangement to the epidermis and variable degrees of hyalinization of arterioles and basement membranes of skin appendages. Fibrinoid degeneration of collagen or blood vessels was not evident in any example studied.
The electron microscopy revealed that the appearance of the dermal collagen from all samples of scleroderma was not different from that observed in normal controls of comparable ages. The impression was gained that a quantitative increase of normal appearing fibers was
CUTANEOUS LESION OF PROGRESSIVE SYSTEMIC SCLEROSIS. JAMA. 1961;175(13):1175. doi:10.1001/jama.1961.03040130059017