title: Loss of hyaluronan in the basement membrane zone of the skin correlates to the degree of stiff hands in diabetic patients.
abstract: Glycosaminoglycans are important components of all extracellular matrices. One of the glycosaminoglycans is hyaluronan, which is ubiquitously distributed throughout the connective tissue. Hyaluronan is especially abundant in the skin, in which it is of both structural and functional importance. This study describes the localization and distribution of hyaluronan in the skin of healthy individuals and of 23 patients with insulin-dependent diabetes mellitus and various degrees of limited joint mobility. In normal skin, hyaluronan staining was seen in all layers but most prominently in the papillary dermis and the basement membrane zone. In the skin from diabetic patients with normal or only moderately restricted mobility of the hands (limited joint mobility grades 0 and 1), the distribution of hyaluronan was similar to that of normal skin. In the skin of patients with severe restriction in joint mobility (limited joint mobility grade 2) the staining pattern was significantly different with weak hyaluronan staining in the papillary dermis and the basement membrane zone almost devoid of hyaluronan. Moreover, an increased epidermal thickness in the latter patients was evident as well as a pronounced hyaluronan staining compared with normal epidermis.
authors.affiliation: Department of Plastic Surgery, University Hospital of Umeå, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Bertheim
authors.forename: Anna
authors.initials: A
authors.lastname: Engström-Laurent
authors.forename: Per-Ake
authors.initials: PA
authors.lastname: Hofer
authors.forename: Peter
authors.initials: P
authors.lastname: Hallgren
authors.forename: Johan
authors.initials: J
authors.lastname: Asplund
authors.forename: Sten
authors.initials: S
authors.lastname: Hellström
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D016022:Case-Control Studies; D046508:Culture Techniques; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology*; D004817:Epidermis / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis / Q000378:metabolism*; D007150:Immunohistochemistry; D007592:Joint Diseases / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012879:Skin Physiological Phenomena
chemical_list: D006820:Hyaluronic Acid