Vol.23 No.6

Original Article

Dermal mast cell density in fingers reflects severity of skin sclerosis in systemic sclerosis

Authors

Sonosuke Yukawa1 , Kunihiro Yamaoka1 , Norifumi Sawamukai1 , Shohei Shimajiri2 , Satoshi Kubo1 , Ippei Miyagawa1 , Koshiro Sonomoto1 , Kazuyoshi Saito1 , Yoshiya Tanaka 1

  • The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu Fukuoka, 807-8555, Japan
  • Second Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu Fukuoka, 807-8555, Japan
Received:

21 September 2012

Accepted:

5 December 2012

Published online:

28 December 2012

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Abstract

Background Systemic sclerosis (SSc) is characterized by skin sclerosis, which develops from the distal extremities and spreads to the trunk. Although several reports have implied the involvement of mast cells in SSc based on examination of forearm skin specimens, there have been no studies that examined digital skin specimens.
Methods Skin biopsies were obtained from the distal onethird of the forearm and between distal and proximal interphalangeal joints from 46 SSc patients, as well as from 29 non-SSc patients and normal controls. Dermal mast cells were detected histologically using NanoZoomer digital pathology.
Results Dermal mast cell density was significantly higher in both the forearms and fingers in SSc patients compared with non-SSc patients and normal controls. Digital dermal mast cell density was significantly higher in patients with diffuse cutaneous SSc than in local cutaneous SSc patients and also in the anti-topoisomerase I antibody-positive group than in the negative group, though such tendency was not noted in the forearm dermis. Interestingly, digital dermal mast cell density tended to correlate negatively but significantly with disease duration, suggesting the possible involvement of dermal mast cells in the early pathological process.
Conclusion Digital accumulation of toluidine blue- and/or c-Kit-positive dermal mast cells appears to be involved in the early stages of the pathological processes of SSc, especially
in patients positive for anti-topoisomerase I antibody.

Key words

Systemic sclerosis, Scleroderma, Mast cells, Inflammation, Pathology