| Nonspecific capillary proliferation and vasculopathy indicate skin hypoxia in erythromelalgia. | |
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MedLine Citation:
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PMID: 21079053 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To report on the histopathologic findings of affected skin in consecutively collected biopsy specimens from 49 patients with erythromelalgia (EM). DESIGN: Skin biopsy specimens were obtained from the foot arch and analyzed by light microscopy, immunofluorescence microscopy, and electron microscopy. SETTING: Oslo University Hospital-Gaustad, University of Oslo, Oslo, Norway. PARTICIPANTS: Thirty-one patients had primary EM, 17 patients had secondary EM, and 1 patient had erythromelalgic syndrome. Main Outcome Measure Evidence of microvascular abnormalities in skin biopsy specimens. RESULTS: Light microscopy showed evidence of capillary proliferation in 10 of 31 patients with primary EM and in 1 of 17 patients with secondary EM. The biopsy specimen from the patient with erythromelalgic syndrome showed numerous capillary nests with endothelial cell defects and a slight perivascular inflammatory reaction. Among the 17 secondary EM cases, sparse perivascular lymphocyte infiltrations were observed in the biopsy specimens from 2 patients with chronic myelogenous leukemia and 1 patient with diabetes mellitus. Eleven patients also had signs of vasculopathy based on findings of immunodeposits of C3 and fibrin. Six of 30 patients with primary EM showed endothelial abnormalities on electron microscopy. All 3 investigations showed unremarkable biopsy results in 16 cases. CONCLUSIONS: Histopathologic analysis is not useful as a routine diagnostic tool in EM because no morphological changes are specific to EM. The capillary proliferation and vasculopathy are assumed to be a consequence of intermittent skin hypoxia (vascular hypothesis of pathogenesis). Whether the proliferation is a consequence of EM or a pathogenic factor in the development of the disease is uncertain. |
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Authors:
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Ole Magne Kalgaard; Ole Petter Clausen; Ove Johan Mellbye; Torstein Hovig; Knut Kvernebo |
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Publication Detail:
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Type: Journal Article Date: 2010-11-15 |
Journal Detail:
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Title: Archives of dermatology Volume: 147 ISSN: 1538-3652 ISO Abbreviation: Arch Dermatol Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372433 Medline TA: Arch Dermatol Country: United States |
Other Details:
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Languages: eng Pagination: 309-14 Citation Subset: AIM; IM |
Affiliation:
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Department of Dermatology, University of Oslo, Frogner Helsesenter, Frederik Stangs gate11-13, 0264 Oslo, Norway. o-kalga@online.no. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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