Dermatosclerosis

DERMATOSCLEROSIS, a collective term denoting in dermatology that condition of the skin which clinically expresses itself as its hardening and loss of elasticity. The most outstanding and constant clinical symptom of D.—difficulty or impossibility of gathering the skin into a fold—depends on the transformation of the normal connective tissue of the skin into a tissue poor in cellular elements, coarsely fibrous and compact fibrous tissue with preservation, multiplication or, conversely, destruction of the elastic fibers. The tight mobility of the skin normal in structure or even its complete immobility, depending on the increase in volume of the deeper tissues (due to tumors, productive inflammation, hypertrophic conditions, solid edema, etc.), despite the external similarity to D., should in no way be confused with it. The skin in D. may retain its normal thickness, but it may also be thickened or thinned to various degrees. It is understandable that sclerosis of the skin, especially a long-existing one, can cause atrophy of the skin, so that both sclerosis and atrophy often exist simultaneously. Sclerosis may involve only the skin or, together with it, the subcutaneous tissue (sometimes together with deeper tissues). In the latter case, the skin appears as if fused with the deeper parts. The color of the skin in D. is rarely normal; more often the skin is achromic, sometimes to the shade of snow-white, or hyperpigmented, even to the color of dark bronze. Along with this, telangiectasias of the skin capillaries, expanded trunks or nodes of ectatic skin veins, foci of skin hemorrhages in various stages of evolution, scars of various sizes, etc., may be observed. Dermatosclerosis may be diffuse and even universal or limited in the form of disks or bands of various shapes, sometimes ring-like surrounding a limb. Pathogenetically, the following are distinguished: congenital forms, very rare forms that can be classified in the group of developmental defects; primary forms of the scleroderma type, which, at least for universal forms, belong to the class of endocrine-vegetative disorders, and secondary forms as a consequence of inflammatory phenomena, venous or lymphatic stasis, etc. Stagnant D. of the legs is particularly common as a consequence of stagnant venous angiodermatitis. Local treatment aims to improve the conditions of lymphatic and blood circulation in the skin and to soften its hardening; for this purpose, massage, diathermy, warm baths or compresses, steam baths or hot-air baths, etc., are appropriate. General treatment, depending on the etiological factors, is pluriglandular in universal scleroderma, specific in some forms of angiodermatitis, etc.