Scanning electron microscopy of lichen sclerosus

Abstract

Lichen sclerosus is an acquired inflammatory condition characterized by whitish fibrotic plaques, with a predilection for the genital skin. We performed scanning electron microscopy of the dermis from a lesion of lichen sclerosus. Normal collagen fibers could be easily found in deeper layers of the specimen, as well as the transition to pathologic area, which seems homogenized. With higher magnifications in this transitional area collagen fibers are adherent to each other, and with very high magnifications a pearl chain aspect became evident along the collagen fibers. In the superficial dermis this homogenization is even more evident, collagen fibers are packed together and round structures are also observed. Rupture of collagen fibers and inflammatory cells were not found. These autoimmune changes of the extracellular matrix lead to the aggregation of immune complexes and/or changed matrix proteins along the collagen fibers, the reason why they seem hyalinized when examined by light microscopy.

Ultrastructural aspects of pseudoxanthoma elasticum

“…9 , 10 Although the use of SEM is not usual in conditions with dermal involvement, it can also contribute by describing three-dimensional features of connective tissue changes. 11 As an example, clumping of elastic fibers was demonstrated in a previous report with SEM. 12 …”

Extragenital bullous lichen sclerosus on the anterior lower extremities: report of a case and literature review

“…Advanced features include follicular plugging, telengiectasia, and bullous and hemorrhagic lesions, which are caused by the fragility of a flattened epidermal-dermal interface [2,4]. Histologic features include epidermal atrophy, luminal hyperkeratosis, follicular plugging, edematous homogenized superficial dermis, dilated blood vessels, loss of rete ridges, hydropic degeneration of the basal layer, and a dermal lymphocytic infiltrate that is sometimes referred to as band-like [2,8,9]. Rarely, as in our patient, a subepidermal blister can be present.…”

Pretibial myxoedema: a case report with scanning electron microscopy

“…4 Few reports were published about retrospective testing of bowel biopsy samples for C. trachomatis DNA and LGV serovar in patients with confirmed or suspected LGV. 4,7 Our case shows that, in patients with ulcers in the proximal rectum, standard rectal swab is likely to fail to identify the disease. In our patients, sampling swab was repeatedly negative as it is normally only about 15 cm long.…”

“…[1][2][3] The disease is characterized by bacterial overgrowth forming nodular concretions, usually of yellow colour (infrequently black or reddish), which are firmly attached to the hair shaft. 1,4 Clinical hallmarks are rancid, acidic odour, unpleasant 'dirty' sensation and staining of clothes. Although most cases have been associated with different species of corynebacteria, the full aetiologic spectrum of this infection is uncertain.…”

“…It separates, disrupts and covers most of the collagen fibres, but it does not assume a peculiar morphological appearance as it does in amyloidosis (stone-like appearance) 3 and in lichen sclerosus and atrophicus (a pearl necklace appearance). 4 SEM is not used routinely; however it can provide additional ultrastructural information of conditions with dermal involvement.…”