Vignale R, Panuncio A, Saralegui P, Di Matteo C, Civila E

Idioma: Ingles.
Referencias bibliográficas: 38
Paginas: 111-116
Archivo PDF: 754.00 Kb.

RESUMEN

La lipodermatoeslerosis (LDS) o paniculitis esclerosante es una induración del dermis, hipodermis y en ocasiones de la fascia superficial. Es un proceso inflamatorio crónico relacionado a una patología venosa, con neovascularización, necrosis grasa y fibrosis. Se postulan varias hipótesis patogénicas, pero el mecanismo exacto se desconoce. En este trabajo estudiamos 6 biopsias cutáneas de 6 pacientes portadores de lipodermatosclerosis crónica. Realizamos estudios inmunohistoquímicos para metaloproteinasas 1, 2 y 3; CD68, actina alfa de musculo liso y cortes semifinos de material incluído en plástico. Nuestros principales hallazgos fueron: los vasos venosos estaban alterados, con luces estrechadas con hiperplasia y fibrosis intimal, algunos vasos arteriales también mostraron fragmentación y reduplicación de la capa elástica interna con fibrosis subintimal. Se encontró una marcada desorganización de la dermis reticular e hipodermis debido a la intensa fibrosis. Se observó asimismo, necrosis grasa pseudomembranosa y pseudoquistes con un infiltrado inflamatorio mixto de disposición parcheada. Las metaloproteinasas 1, 2 y 3 fueron positivas en la epidermis, células endoteliales, algunas células dérmicas e hipodérmicas, alrededor de los pseudoquistes y de necrosis grasa pseudomembranosa. En cortes semifinos de plástico, se observó la presencia de gotas lipídicas entre las fibras colágeno, inclusive en la dermis superficial.

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