PMID- 8543305
OWN - NLM
STAT- MEDLINE
DCOM- 19960212
LR  - 20190722
IS  - 0046-8177 (Print)
IS  - 0046-8177 (Linking)
VI  - 27
IP  - 1
DP  - 1996 Jan
TI  - The role of microvascular injury in the pathogenesis of cutaneous lesions of 
      dermatomyositis.
PG  - 15-9
AB  - Although microvascular injury has been postulated as the pathogenetic basis of 
      skeletal muscle injury in dermatomyositis (DM), its role in the genesis of the 
      skin lesions, which are said to be difficult to distinguish light microscopically 
      from systemic lupus erythematosus (SLE) and subacute lupus erythematosus (SCLE), 
      has not been analyzed. The authors' intention was to assess the role of 
      microvascular injury in the pathogenesis of skin lesions in DM, SLE, and SCLE. 
      Light microscopic features of biopsies of lesional skin from 20 patients with 
      myopathic DM and 11 with amyopathic DM were compared to eight lesional skin 
      biopsies from eight patients with SLE and 12 lesional skin biopsies from 12 
      patients with SCLE. Vascular density was compared in the three groups using an 
      immunohistochemical preparation with an antibody to factor VIII. In 12 biopsies 
      from the DM group, and in 19 of 20 lupus erythematosus (LE) specimens, frozen 
      tissue was available. An indirect immunofluorescence methodology was used to 
      detect C5b-9 deposition, and direct immunofluorescence studies for other 
      immunoreactants were performed in standard fashion. Compared with LE, lesions of 
      DM showed a greater degree of endothelial injury, vascular ectasia, and vascular 
      fibrin deposition; there were no differences between myopathic versus amyopathic 
      DM. C5b-9 deposition in vessels was significantly greater in DM than in LE. The 
      superficial vascular plexus density was reduced in lesions of DM versus LE 
      control groups with the greatest reduction observed in myopathic DM. Epithelial 
      injury and mucin was greatest in myopathic DM. Microvascular injury is the 
      apparent pathophysiological basis of skin lesions in DM. Careful attention to 
      microvascular pathology enables distinction of DM from SLE and SCLE. Indirect 
      immunofluorescence testing using a monoclonal antibody to C5b-9 is a valuable 
      tool to distinguish DM from LE in biopsies of lesional skin.
FAU - Crowson, A N
AU  - Crowson AN
AD  - Central Medical Laboratories, Misericordia General Hospital, Winnipeg, Manitoba, 
      Canada.
FAU - Magro, C M
AU  - Magro CM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Hum Pathol
JT  - Human pathology
JID - 9421547
RN  - 0 (Complement Membrane Attack Complex)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Complement Membrane Attack Complex/analysis
MH  - Dermatomyositis/metabolism/*pathology/physiopathology
MH  - Female
MH  - Fluorescent Antibody Technique, Direct
MH  - Humans
MH  - Lupus Erythematosus, Systemic/metabolism/*pathology/physiopathology
MH  - Male
MH  - Microcirculation/pathology
MH  - Microscopy, Electron
MH  - Middle Aged
MH  - Skin/*blood supply/pathology
EDAT- 1996/01/01 00:00
MHDA- 1996/01/01 00:01
CRDT- 1996/01/01 00:00
PHST- 1996/01/01 00:00 [pubmed]
PHST- 1996/01/01 00:01 [medline]
PHST- 1996/01/01 00:00 [entrez]
AID - S0046-8177(96)90132-X [pii]
AID - 10.1016/s0046-8177(96)90132-x [doi]
PST - ppublish
SO  - Hum Pathol. 1996 Jan;27(1):15-9. doi: 10.1016/s0046-8177(96)90132-x.