S9C15P7-3: In this old lesion of morphea, sweat glands are entrapped in the dermis; some of the glands are dilated and their adventitia is fibrotic. The area below the arrows is a clear marker for a late stage in the evolution of the substitutive fibrosis of morphea . The collagen bundles are swollen and more brightly acidophilic below the blue arrows. The interface is straight. The sclerosis also has extended upward into the dermis above the blue arrows, but the patterns are not as well-developed.

S9C15P7-4: The interface between the dermis and the subcutaneous fat is straight from side to side (“squared-off”). Collagen bundles at the interface are streaked in a direction that is parallel to the surface of the skin. At the bottom of the field, a septum is coarsened (van Giesen stain).

S9C15P7-5: With a Masson trichrome stain, the straight interface is well-defined. The traceries in red among the lipocytes, at the interface between the “dermis” and the fat, represent fibrocytes and lymphoid cells among lipocytes. The process of substitutive fibrosis will progress in this area. In the process, the dimensions of the dermis will be augmented. The domain of the adipose tissue will be diminished to a degree that will be comparable to expansion of the domain of the reticular dermis.

S9C15P7-6: Under polarized light, the streaking of collagen bundles (bright yellow bundles) is accentuated; the bundles are oriented in a direction that parallels the surface of the skin.

S9C15P7-7: Interface changes are associated with a mild lymphohistiocytic collagenosis. Spaces among collagen bundles are widened (edema?). The interface is straight. Collagen bundles are fissured and pock-marked (morphea).

S9C15P7-8: The dermis extends well below the level of the sweat glands. The sweat glands are somewhat atrophic; their adventitia, which is usually adipose tissue, has been replaced by a fibrous mat continuous with the neighboring reticular dermis. Red arrows mark the interface between a band of streaked collagen bundles and the more normal appearing, and more superficial, reticular dermis. Usually sweat glands provide a marker for the lower boundary of the normal reticular dermis. The patterns provide evidence of a sclerosing process, that, as it expands into fat and the more superficial reticular dermis, will alter the quality and quantity of fibrous tissue. In the act, the vertical dimensions of the fibrous domain will be increased. The vertical dimensions of the reticular dermis, as representative of the fibrous domain, will be expanded. The pattern of collagen bundles of the expanded dermis will be altered; the interface with the fat will be straightened (as it is in this field).