Although the histology of Duputyren's tissue is well-documented, conventional stains do not distinguish between the different types of collagen which biochemistry and immunochemistry suggest are present. Duputyren's specimens [nodules (n = 26), cords (n = 15) and dermofasciectomies (n = 6)] were stained with haematoxylin and eosin, Van Gieson's Mallory's, Masson's, and Herovici's picropolychrome stain, and examined for both cellularity and collagen staining characteristics. All stains illustrated the marked cellularity of the nodules, contrasting with a paucity of cells within the cords. The first four stains demonstrated uniformity of the collagen staining within the tissues. Herovici's picropolychrome, however, showed distinct staining patterns for the dermis, nodules and cords, with both purple/red and blue areas. Other studies suggest that those fibres stained purple/red and blue are types I and III collagens respectively. These findings may shed further light on the tissue of origin of Duputyren's disease.
Histologically, Dupuytren's disease has been compared to the process of neoplasia because of fibroblast proliferation, recurrence, chromosomal abnormalities and antigenic profiles. However, a comparison of Dupuytren's tissue with the granulation tissue formed in wound healing could be more valid. Histology reveals similarities in cell types, proliferation, vascularity and collagen morphology. Pharmacologically, both tissues have a similar range of agonist and antagonist responses. Biochemical analysis reveals new collagen synthesis, an increased ratio of type III to type I collagen, and similar changes of the ground substance in both processes. Considering such similarities perhaps it is possible to regard some of the models used for the investigation of wound healing and granulation tissue as the missing experimental "model" for the study of Dupuytren's disease. Recently great strides have been made in the basic understanding of wound biology, and such a comparison might well provide novel therapeutic options for Dupuytren's disease.
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