|
Substitutive Fibrosis
(Interface Fibrosis)
The fibrosing process, which extends as a fibrous mat into the fat in a lesion of morphea, qualifies as a
substitutive fibrosis (S9C14VA1-1); in the process, newly formed fibrous tissue replaces a portion of the
domain of the fat. Initially, the fibrous tissue is delicate
and variably inflamed. In this stage, some of the lipocytes are entrapped in the newly formed fibrous tissue. Substitutive fibrosis, in this pattern and at this interface, is not peculiar to morphea; similar patterns may be encountered in lesions such as necrobiosis lipoidica diabeticorum and lupus profundus.
In areas of sclerosis in which collagen bundles are coarsened, new fibrils are found in the spaces among the
coarse collagen bundles (S9C16P8-1). This pattern in which new fibrils are added to the old bundles might be
characterized as accretive fibrosis. The accretion of fibrils at the surface of old, coarse bundles sometimes produces a pattern in which the old bundle is outlined by a peripheral bundle in a concentric pattern
(collagenous ring-binding) (S9C16P8-5).
Connolly SM, et al: Scleroderma and L-tryptophan: a possible explanation of the eosinophilia-myalgia syndrome.
1990;23: 451-7.
Buechner SA, Rufli T: Atrophoderma of Pasini and Pierini: clinical and histopathologic findings and antibodies
to Borrelia Burgdorferi in thirty-four patients. J Am Acad Dermatol 1994;30: 441-6.
|
