Pericapillary fibrin in the ulcer-bearing skin of the leg: the cause of lipodermatosclerosis and venous ulceration. 1982

K G Burnand, and I Whimster, and A Naidoo, and N L Browse

Forty-one biopsy specimens, taken from the ulcer-bearing skin of 41 legs of 21 patients attending the varicose vein clinic, were selectively stained for fibrin with phosphotungstic acid haemotoxylin before being blindly assessed,. Layers of fibrin were found surrounding the dermal capillaries in all 26 legs with lipodermatosclerosis. None of the specimens from the 15 legs with clinically normal skin contained fibrin. There was also an increased number of dermal capillaries cut in cross section per high powered field in 24 of the 26 legs with lipodermatosclerosis compared with two of the 15 legs with normal skin (p less than 0.001). The mean reduction in foot vein pressure during exercise was significantly less in the 26 limbs with pericapillary fibrin than in the other 15 limbs (p less than 10(-6). Lipodermatosclerosis is synonymous with pericapillary fibrin deposition and is associated with, and probably secondary to, both a persistently raised venous pressure and an increase in the size of the dermal capillary bed. This extravascular deposition of fibrin probably stimulates tissue fibrosis and blocks the diffusion of oxygen to the overlying epidermis, producing cellular death and venous ulceration.

UI MeSH Term Description Entries
D007871 Leg Ulcer Ulceration of the skin and underlying structures of the lower extremity. About 90% of the cases are due to venous insufficiency (VARICOSE ULCER), 5% to arterial disease, and the remaining 5% to other causes. Leg Ulcers,Ulcer, Leg,Ulcers, Leg
D008297 Male Males
D002196 Capillaries The minute vessels that connect arterioles and venules. Capillary Beds,Sinusoidal Beds,Sinusoids,Bed, Sinusoidal,Beds, Sinusoidal,Capillary,Capillary Bed,Sinusoid,Sinusoidal Bed
D005260 Female Females
D005337 Fibrin A protein derived from FIBRINOGEN in the presence of THROMBIN, which forms part of the blood clot. Antithrombin I
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012594 Scleroderma, Localized A term used to describe a variety of localized asymmetrical SKIN thickening that is similar to those of SYSTEMIC SCLERODERMA but without the disease features in the multiple internal organs and BLOOD VESSELS. Lesions may be characterized as patches or plaques (morphea), bands (linear), or nodules. Dermatosclerosis,Morphea,Scleroderma, Circumscribed,Frontal Linear Scleroderma en Coup de Sabre,Linear Scleroderma,Scleroderma, Linear,Circumscribed Scleroderma,Localized Scleroderma,Morpheas,Sclerodermas, Localized
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.
D014647 Varicose Ulcer Skin breakdown or ulceration in the drainage area of a VARICOSE VEIN, usually in the leg. Stasis Ulcer,Venous Ulcer,Venous Hypertension Ulcers,Venous Stasis Ulcers,Hypertension Ulcer, Venous,Hypertension Ulcers, Venous,Stasis Ulcer, Venous,Stasis Ulcers,Stasis Ulcers, Venous,Ulcer, Stasis,Ulcer, Varicose,Ulcer, Venous,Ulcer, Venous Hypertension,Ulcer, Venous Stasis,Ulcers, Stasis,Ulcers, Varicose,Ulcers, Venous,Ulcers, Venous Hypertension,Ulcers, Venous Stasis,Varicose Ulcers,Venous Hypertension Ulcer,Venous Stasis Ulcer,Venous Ulcers

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