title: Lack of evidence for bacterial infections in skin in patients with systemic sclerosis.
abstract: BACKGROUND
  In some patients with systemic sclerosis (SSc), persistent bacterial infection involving dermal microvascular endothelial cells may result in endothelial injury, leading to the obliterative microvasculopathy typical of the disease. Alternatively, in some patients with SSc persistent bacterial infection involving activated dermal fibroblasts or other cells found in scleroderma skin might result in the fibrosing features of this disease. In this study, we investigated bacterial infection in skin in patients with SSc.
  
  
  METHODS
  Chlamydiae of many species are known to undergo persistent infection. Highly sensitive and specific PCR assays targeting chromosomal DNA sequences from C. trachomatis and C. pneumoniae were used to screen skin biopsy samples from each of 18 patients and 26 control individuals. Additional screening was performed using a highly sensitive "pan-bacteria" PCR screening system.
  
  
  RESULTS
  All patient and control samples proved to be PCR-negative for both chlamydial species. Similarly, all patient and control samples were PCR-negative when the broad range pan-bacteria assay system was used.
  
  
  CONCLUSIONS
  Although some caveats apply, the data presented here do not support the contention that persistent bacterial infections play an important role in the pathogenesis of SSc.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Clinical Immunogenetics, University of Texas Houston Health Sciences Center, Medical School Houston, Texas, USA.
authors.forename: Maureen D
authors.initials: MD
authors.lastname: Mayes
authors.forename: Judith A
authors.initials: JA
authors.lastname: Whittum-Hudson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Oszust
authors.forename: Hervé C
authors.initials: HC
authors.lastname: Gérard
authors.forename: Alan P
authors.initials: AP
authors.lastname: Hudson
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology*; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D017192:Skin Diseases, Bacterial / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology*
chemical_list: D004269:DNA, Bacterial