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Pathological changes of arterio-venous anastomoses (AVA) of the fingertips in normal and affected skin of psoriatic patients

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Summary

We have examined the morpho-histochemical patterns of arteriovenous anastomoses (AVA) and of ground substance mucopolysaccharides in 17 psoriatic patients using the finger-tip biopsy technique. Eight of these patients had finger-tip lesions.

As controls, biopsies from eight healthy subjects and five affected with various dermatoses were examined.

The AVA showed serious pathological changes in the cases with psoriasis, even in non-affected finger-tips. They consisted in early arteriosclerotic lesions and increase of intraglomic acid mucopolysaccharides.

In diffuse erythrodermic psoriasis, the AVA were dissociated and infiltrated by lymphoid cells, with severe degenerative changes.

The early and diffuse alterations of the AVA substantiate the biomicroscopical observations and especially the capillary winding.

It therefore, seems justified to speak of microangiopathia psoriatica where precapillary alterations and pathological changes of the ground substance play a significant role.

Zusammenfassung

Das histochemische Verhalten von arterio-venösen Anastomosen (AVA) und der Grundsubstanz-Mucopolysaccharide wurde bei 17 Patienten in Biopsien von der Fingerbeere untersucht. Acht dieser Patienten hatten Erscheinungen an den Fingerspitzen.

Fingerbeerenbiopsien von 8 gesunden und 5 an verschiedenen anderen Dermatosen erkrankten Probanden dienten als Kontrolle. Schwere pathologische Veränderungen der AVA wurden bei 5 Fällen mit Psoriasis auch in nichterkrankten Fingerspitzen beobachtet. Sie bestanden in frühzeitig erkennbaren, arteriosklerotischen Veränderungen mit Vermehrung der intraglomischen sauren Mucopolysaccharide.

Bei psoriatischer Erythrodermie zeigten sich im Bereiche der AVA lymphoide Zellinfiltrate und schwere Degenerationszeichen. Die frühzeitig erkennbaren und diffusen Veränderungen der AVA stehen in Beziehung zu bio-mikroskopischen Beobachtungen, besonders an den Capillarwindungen.

Der Begriff: Microangiopathia psoriatica erscheint daher berechtigt, da präcapilläre Veränderungen und Störungen in der Grundsubstanz eine bedeutsame Rolle spielen.

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  1. Dermatological Division, Hospital of Monza and Center of Molecular Biology, Milan, Italy

    L. Levi & S. B. Curri

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  1. L. Levi
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  2. S. B. Curri
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Levi, L., Curri, S.B. Pathological changes of arterio-venous anastomoses (AVA) of the fingertips in normal and affected skin of psoriatic patients. Arch. Derm. Forsch. 246, 59–69 (1973). https://doi.org/10.1007/BF00595488

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