Аннотация
Background: The diagnosis of idiopathic atrophoderma of Pasini and
Pierini (IAPP) relies on typical clinical features, particularly
distinctive pigmented ovular/round depressed plaques. Histologic
examination often reveals no obvious changes, but patterns of collagen
distribution, using multiphoton imaging and second harmonic generation
can help track hidden details of tissue organization contributing to
atrophy.
Objective: To identify histologic features that distinguish IAPP from
unaffected skin.
Methods: Eleven patients were included for conventional analyses. Masson
trichromee and Unna-Tanzer orcein-stained sections were evaluated using
automated morphometry. Hematoxylin-eosinestained sections were analyzed
by multiphoton imaging using 2-photon excited fluorescence and second
harmonic generation.
Results: No abnormalities were found under light microscopy or by
automated quantification. Multiphoton imaging revealed no difference in
optical density of either collagen or elastic fibers in lesioned and
unaffected skin; however, horizontal collagen fiber organization in
lesion specimens increased toward the lower dermis, whereas elastic
fibers featured greater disorganization within the upper dermis.
Limitations: The low number of patients evaluated.
Conclusion: The atrophic appearance of IAPP lesions reflects changes in
organization, but not in collagen and elastic tissue content. Minute
organizational differences that are imperceptible to the experienced
pathologist and undetectable by automated analyses were revealed by
multiphoton analyses, particularly second harmonic generation, in
association with texture analyses.
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