Sclerosis of the skin

Skin sclerosis(sclerosis from the Greek skleros = hard) is a hardening of the skin in the literal sense of the word. It is based on an overproduction of collagen, i.e. the collagen fiber content per unit of tissue is increased. The mechanism of this overproduction is unclear, but presumably of various kinds. Sclerosis of the skin is primarily a phenomenon of the deep, reticular dermis. The neighboring compartments such as the papillary dermis, fatty tissue and fascia are also affected to varying degrees. Their varying involvement defines the clinical picture of skin sclerosis.

In the case of sclerosis of the papillary dermis, the skin appears silvery-white. The papillary sclerosis covers the autochthonous skin color, which is characterized by the translucent shade of the papillary blood vessels. The consequence is a localized whitening effect. In the marginal area of the inflammatory process, where the sclerosis is not yet present, the red tone of the hyperemic inflammation characterizes the skin color. This erythematous border is known as the lilac ring and is characteristic of the morphea type of circumscribed scleroderma.

The term skin sclerosis as a pathological-anatomical term is not to be equated with the diagnosis "scleroderma". The non-monoorganic scleroderma of the skin is referred to as "circumscribed scleroderma/morphea". The polyorganic multisystemic disease "systemic scleroderma" is also referred to as "systemic sclerosis", which naturally contributes to confusion of the term. Both diseases, systemic scleroderma and circumscribed scleroderma, are characterized by fibrosis and subsequent sclerosis of the skin; systemic scleroderma is also characterized by fibrosis of internal organs.