title: Dermal mast cell density in fingers reflects severity of skin sclerosis in systemic sclerosis.
abstract: BACKGROUND
  Systemic sclerosis (SSc) is characterized by skin sclerosis, which develops from the distal extremities and spreads to the trunk. Although several reports have implied the involvement of mast cells in SSc based on examination of forearm skin specimens, there have been no studies that examined digital skin specimens.
  
  
  METHODS
  Skin biopsies were obtained from the distal one-third of the forearm and between distal and proximal interphalangeal joints from 46 SSc patients, as well as from 29 non-SSc patients and normal controls. Dermal mast cells were detected histologically using NanoZoomer digital pathology.
  
  
  RESULTS
  Dermal mast cell density was significantly higher in both the forearms and fingers in SSc patients compared with non-SSc patients and normal controls. Digital dermal mast cell density was significantly higher in patients with diffuse cutaneous SSc than in local cutaneous SSc patients and also in the anti-topoisomerase I antibody-positive group than in the negative group, though such tendency was not noted in the forearm dermis. Interestingly, digital dermal mast cell density tended to correlate negatively but significantly with disease duration, suggesting the possible involvement of dermal mast cells in the early pathological process.
  
  
  CONCLUSIONS
  Digital accumulation of toluidine blue- and/or c-Kit-positive dermal mast cells appears to be involved in the early stages of the pathological processes of SSc, especially in patients positive for anti-topoisomerase I antibody.
authors.affiliation: The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu, Fukuoka, 807-8555, Japan.
authors.forename: Sonosuke
authors.initials: S
authors.lastname: Yukawa
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamaoka
authors.forename: Norifumi
authors.initials: N
authors.lastname: Sawamukai
authors.forename: Shohei
authors.initials: S
authors.lastname: Shimajiri
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kubo
authors.forename: Ippei
authors.initials: I
authors.lastname: Miyagawa
authors.forename: Koshiro
authors.initials: K
authors.lastname: Sonomoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Saito
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005385:Fingers / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D008297:Male; D008407:Mast Cells / Q000473:pathology*; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000473:pathology*; D012720:Severity of Illness Index; D012867:Skin / Q000098:blood supply / Q000473:pathology*