Scleroderma

Scleroderma. The dermis is characterized by large reticular dermal collagen bundles that are oriented parallel to the epidermis. The large size and loss of basket-weave pattern of these collagen bundles are abnormal. No appendages are apparent, as these are destroyed in the disease process.

scleroderma: early stage

Scleroderma: hand, amputated distal digits

<bold>FIG. 77.6.</bold> Close-up hand roentgenogram of a 46-year-old woman with limited cutaneous systemic sclerosis. Note extensive subcutaneous calcinosis.

<bold>FIG. 77.11.</bold> Photomicrograph of the lung of a 52-year-old woman with diffuse cutaneous systemic sclerosis who died as the result of respiratory insufficiency. Note the dramatic interstitial fi osis and dilatation of air sacs (honeycomb lung).

<bold>FIG. 77.20.</bold> A child with linear scleroderma involving the left lower extremity with evidence of a left knee flexion contracture. There is a plaque of morphea on the right thigh.

FIG. 2.17. Juvenile dermatomyositis and scleroderma. A: Atrophic, hypopigmented lesions overlying extensor surfaces of interphalangeal joints, with periungual erythema typical of juvenile dermatomyositis. B: Linear scleroderma involving left lower extremity in a 12-year-old girl.

Figure 10-195 <bold>SCLERODERMA: ACROOSTEOLYSIS. A. PA Hand.</bold> Note the early resorption of the distal tufts (<italic>arrows</bold>). Incidentally noted is a bandage (<italic>arrowhead</bold>). <bold>B. PA Hand.</bold> Observe the advanced resorption of the distal tufts.

Linear scleroderma: leg

<bold>FIG. 77.2.</bold> Face of a 19-year-old woman with diffuse cutaneous systemic sclerosis. Note loss of normal skin folds and retraction of lips.

Morphea: abdomen