Scleroderma and the Structural Basis of Skin Compliance

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Abstract
The architecture and fiber structure of the dermis in scleroderma were compared to normal skin using techniques of polarization microscopy, horizontal sectioning, and manipulation of fresh tissue under the microscope. Sclerodermatous skin was not significantly different from normal in any of the structural features studied, yet skin compliance, which is an intrinsic property of normal dermal architecture, was markedly reduced. Manipulation of thin, fresh tissue sections under the microscope indicated that loss of compliance was probably related to abnormally strong adhesive forces bonding together otherwise normal fibers. By contrast, in compliant, normal skin, independent fiber mobility was consistently demonstrated. With routine microscopy, the appearance that the structure of the dermis in scleroderma is altered is probably produced by the close compacting of fibers that are abnormally adherent but show no structural alteration.