Alterations of Basement Membrane Zone and Cutaneous Microvasculature in Morphea and Extragenital Lichen Sclerosus

Abstract

The aim of this study was to compare alterations of the basement membrane zone (BMZ) and to visualize changes within the skin vascular network in morphea and extragenital lichen sclerosus with the use of laser scanning confocal microscopy. This work was performed in eight plaques of morphea (three active and five inactive) and eight of lichen sclerosus (three of short duration and five long-lasting). Biopsy specimens from six healthy individuals served as controls. The biopsies were cut into 40-microm-thick sections, labeled with antibodies against beta4-intergin (a lamina lucida marker), collagen IV, and the N-terminal end of collagen VII (lamina densa markers) and C-terminal end of collagen VII (a sublamina densa marker) and studied using laser scanning confocal microscopy. Three-dimensional reconstruction of various regions of the BMZ showed a decreased number and size of the dermal papillae both in morphea and lichen sclerosus compared with normal skin. In morphea, the continuity of the BMZ at the level of lamina lucida, lamina densa, and sublamina densa was preserved whereas in LS numerous invaginations and holes were present in the BMZ at the level of the lamina lucida and lamina densa. Thus the alterations of the BMZ in morphea differ from those in lichen sclerosus. Three-dimensional reconstruction of the skin vascular network showed increased angiogenesis only in the early inflammatory stage of morphea, whereas in inactive morphea and lichen sclerosus various numbers of enlarged vessels were visible. The changes in the vascular network in morphea appear to be related to the activity of the disease.

Clinicopathological Study of Lichenoid Reactions: A Retrospective Analysis

“…Subepidermal bulla noticed in the bullous lichen planus was a typical feature as reported by authours 24,25 in earlier reports and studies. Lichen sclerosus et atrophicus characteristic feature of follicular plugging was seen in both the specimen which has also been noticed by Kowalewski et al 26 Parakeratosis was seen in oral lichen planus specimen. Parakeratosis was most consistent finding in specimen of oral lichen planus which was analogous to findings of Chatterjee K et al in their study.…”

The use of doppler ultrasound to evaluate lesions of localized scleroderma

“…Active LS lesions could be expected to have hyperemia as they are often warm, red, and/or violaceous, and have been found to have neovascularization on pathology [4]. Compared with inactive lesions, increased surface temperature and increased blood fl ow have been detected in active lesions by thermography and laser Doppler fl owmetry, respectively [46].…”

“…In both LS and systemic sclerosis (SSc), initial infl ammatory cell infi ltration of the reticular dermis is followed by abnormal collagen synthesis [2,3]. In active lesions, increased vascularity, including an increased number of vessels and enlarged and tortuous vessels, is found [4]. With time, the infl ammatory infi ltrate, eccrine glands, and other cells are replaced by thickened hypocellular collagen; similar changes occur in the hypodermis and deeper tissues in deep lesions [3,5].…”

Partial Reconstitution of Cutaneous Microvessels in Long-Term Survivors after Allogeneic Bone Marrow Transplantation

“…First, LTS without clinical signs of chronic cutaneous GVHD and healthy controls demonstrate comparable morphological features with respect to dermal matrix and vascular structures (fig. 1) as compared to patients with chronic sclerotic GVHD and lichen sclerosus [14, 16]. Second, quantitative assessment of microvascular density by two independent methods (fig.…”

“…Past investigations elucidated that various immune-mediated fibrosing skin diseases result in similar modifications of vascular structures, cellular and molecular events as well as matrix changes. Vertically oriented capillary loops originating from and terminating in the upper vascular plexus were found to be transpositioned in lichen sclerosus from vertical to horizontal orientation toward the basal membrane zone [16]. Induction of sclerosis in fibrosing skin diseases such as chronic sclerotic GVHD, morphea and lichen sclerosus has been demonstrated to be critically mediated by TGF-β-induced activation of fibroblasts with subsequent collagen production and the simultaneous stimulation of tissue inactivators for metalloproteinases and increases in platelet-derived growth factor-α receptor expression in fibroblasts and endothelial endothelin-1 synthesis [20, 21].…”