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Ultrastructural observations in port wine stains

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Summary

The cause for the progressive vascular dilatation in port wine stains remains unclear. We compared the histology and ultrastructure of lesional and adjacent normal skin in paired biopsy specimens of 12 and 8 patients, respectively (age range, 6 to 53 years). In semithin sections, the lesions of all patients showed ectatic vessels and a fine-fibrous or hyaline thickening of the walls of postcapillary venules, as well as in some instances a loosening of the surrounding connective tissue. Ultrastructurally, the wall material consisted predominantly of peripheral deposits of amorphous material interspersed with collagen fibrils (diameter, 35±4 nm); occasionally the number of basal laminae in the inner part was also increased. Cross-banded filamentous aggregates with a periodicity of 95 nm were observed in and around the walls. The endothelium of many patients displayed fenestrations and/or small gaps. Various kinds of alterations of the intervascular connective tissue were found. We conclude that structural alterations of the vascular and later also of the intervascular connective tissue are related to the dilatation of the vessels. These findings are in agreement with the immunopathologically demonstrated increase of basement membrane components in the same biopsy specimens, but are interpreted as secondary phenomena. Endothelial stability and permeability may also be affected.

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References

  1. Barsky SH, Rosen S, Geer DE, Noe JM (1980) The nature and evolution of port wine stains: a computer-assisted study. J Invest Dermatol 74:154–157

    Google Scholar 

  2. Braverman IM, Fonferko E (1982) Studies in cutaneous aging. II. The microvasculature. J Invest Dermatol 78:444–448

    Google Scholar 

  3. Braverman IM, Keh-Yen A (1981) Ultrastructure of the human dermal microcirculation. III. The vessels in the mid-and lower dermis and subcutaneous fat. J Invest Dermatol 77:297–304

    Google Scholar 

  4. Braverman IM, Keh-Yen A (1983) Ultrastructure and threedimensional reconstruction of several macular and papular telangiectases. J Invest Dermatol 81:489–497

    Google Scholar 

  5. Braverman IM, Keh-Yen A (1984) Ultrastructural abnormalities of the microvasculature and elastic fiber in the skin of juvenile diabetics. J Invest Dermatol 82:270–274

    Google Scholar 

  6. Braverman IM, Keh-Yen A (1986) Three-dimensional reconstruction of endothelial cell gaps in psoriatic vessels and their morphologic identity with gaps produced by the intradermal injection of histamine. J Invest Dermatol 86:577–581

    Google Scholar 

  7. Braverman IM, Yen A (1977) Ultrastructure of the human dermal microcirculation. II. The capillary loops of the dermal papillae. J Invest Dermatol 68:44–52

    Google Scholar 

  8. Braverman IM, Sibley J, Keh-Yen A (1986) A study of the veil cells around normal, diabetic, and aged cutaneous microvessels. J Invest Dermatol 86:55–62

    Google Scholar 

  9. Casley-Smith JR (1983) The structure and functioning of the blood vessels, interstitial tissues, and lymphatics. In: Földi M, Casley-Smith JR (eds) Lymphangiology. Schattauer, Stuttgart New York, pp 27–61

    Google Scholar 

  10. Enjolras O, Riche MC, Merland JJ (1985) Facial port-wine stains and Sturge-Weber syndrome. Pediatrics 76:48–51

    Google Scholar 

  11. Finley JL, Clark AF, Colvin RB, Blackman R, Noe J, Rosen S (1982) Immunofluorescent staining with antibodies to factor VIII, fibronectin, and collagenous basement membrane protein in normal human skin and port wine stains. Arch Dermatol 118:971–975

    Google Scholar 

  12. Fleischmayer R, Perlish JS (1980) Capillary alterations in scleroderma. J Am Acad Dermatol 2:161–170

    Google Scholar 

  13. Higgins JC, Eady RAJ (1981) Human dermal microvasculature. I. Its segmental differentiation. Light and electron microscopic study. Br J Dermatol 104:117–129

    Google Scholar 

  14. Kajikawa K, Nakanishi I, Yamamura T (1980) The effect of collagenase on the formation of fibrous long spacing collagen aggregates. Lab Invest 43:410–417

    Google Scholar 

  15. Kint A, Geerts M-L, Platevoet D (1972) Generalized essential telangiectasia. Arch Belg Dermatol Syph 28:377–385

    Google Scholar 

  16. Kobayasi T, Asboe-Hansen G, Tsurufuji S (1985) Filamentous aggregates of collagen. Ultrastructural evidence for collagen-fibril degradation in situ. Arch Dermatol Res 277:214–219

    Google Scholar 

  17. Kumakiri M, Hashimoto K (1985) Vascular tumors. In: Johannessen JV, Hashimoto K (eds) Electron microscopy in human medicine, vol 11(a). The skin. McGraw-Hill International, New York, pp 87–90

    Google Scholar 

  18. Leu HJ, Wenner A, Spycher MA, Brunner U (1980) Ultrastrukturelle Veränderungen bei venöser Angiodysplasie vom Typ Klippel-Trenaunay. VASA 9:147–151

    Google Scholar 

  19. Marsch WC (1984) Morphologie des Blut- und Lymphgefäß-Systems bei Hautkrankheiten. Eine licht- und elektronenmikroskopische Untersuchung. Habilitationsschrift (Hautklinik und-Poliklinik des Klinikums Charlottenburg der Freien Universität Berlin, Direktor Prof. Dr. G. Stüttgen, im Rudolf Virchow-Krankenhaus, Berlin)

  20. Miescher G (1953) Über plane Angiome (Naevi hyperaemici). Dermatologica 106:176–183

    Google Scholar 

  21. Mitsuhashi Y, Odermatt BF, Schneider BV, Schnyder UW (1988) Immunohistological evaluation of endothelial markers and basement membrane components in port-wine stains. Dermatologica 176:243–250

    Google Scholar 

  22. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–420

    Google Scholar 

  23. Noe JM, Barsky SH, Geer DE, Rosen S (1980) Port wine stains and the response to argon laser therapy: successful treatment and the predictive role of color, age, and biopsy. Plast Reconstr Surg 65:130–136

    Google Scholar 

  24. Ohmori S, Huang C-K (1981) Recent progress in the treatment of port-wine staining by argon laser: some observations on the prognostic value of relative spectro-reflectance (RSR) and the histological classification of the lesions. Br J Plast Surg 34:249–257

    Google Scholar 

  25. Peyrol S, Hugues B, Grimaud JA, Mornex R (1984) Collagen heterogeneity of thickened basement membranes of human diabetic dermis: tissular immunolabelling of collagen types I, III and IV by light and electron microscopy. Cell Molecul Biol 30:43–57

    Google Scholar 

  26. Raff M (1981) Die Bedeutung adrenerger Rezeptoren für die Entstehung des Naevus flammeus und des Naevus anaemicus. Wien Klin Wochenschr [Suppl 129] 93:1–14

    Google Scholar 

  27. Rosen S, Smoller B (1987) Pathogenesis of port wine stains. A new hypothesis. Med Hypotheses 22:365–368

    Google Scholar 

  28. Schnyder UW (1954) Zur Klinik und Histologie der Angiome. 2. Mitteilung: Die Feuermäler (Naevi teleangiectatici). Arch Dermatol Syph (Berl.) 198:51–74

    Google Scholar 

  29. Schnyder UW (1955) Zur Klinik und Histologie der Angiome. 1. Mitteilung: Zur Histologie des Naevus flammeus (Naevus teleangiectaticus). Arch Dermatol Syph (Berl) 200:483–490

    Google Scholar 

  30. Smoller BR, Rosen S (1986) Port-wine stains: a disease of altered neural modulation of blood vessels? Arch Dermatol 122:177–179

    Google Scholar 

  31. Yen A, Braverman IM (1976) Ultrastructure of the human dermal microcirculation: the horizontal plexus of the papillary dermis. J Invest Dermatol 66:131–142

    Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland

    B. V. Schneider, Y. Mitsuhashi & U. W. Schnyder

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  1. B. V. Schneider
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  2. Y. Mitsuhashi
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  3. U. W. Schnyder
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Schneider, B.V., Mitsuhashi, Y. & Schnyder, U.W. Ultrastructural observations in port wine stains. Arch Dermatol Res 280, 338–345 (1988). https://doi.org/10.1007/BF00426611

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