We studied innervation and dermal vasculature in affected and apparently normal skin of sclerodermic patients to evaluate the involvement of different nerve fibre groups and to determine a possible correlation with vascular damage in this disease. Immunohistochemical analysis and confocal microscopic examination of skin biopsy samples were used.

METHODS AND RESULTS

We obtained 3 mm punch skin biopsy samples from the distal thigh and distal leg in 11 consecutive 34–70 year old female patients with systemic sclerosis (SSc), identified by the American College of Rheumatology classification criteria.¹ We excluded patients who had been exposed to potentially neurotoxic exogenous or endogenous conditions. The skin appeared sclerotic in 4/11 patients in the leg and in 3/11 in the thigh (table 1). In four patients a further skin sample from fingertip was taken to evaluate myelinated fibres. None of the patients complained of sensory disturbances, and neurological and neurophysiological evaluations were normal except in two patients, in whom a conduction velocity study showed the presence of an entrapment syndrome. Patient morphological findings were compared with data …