[Antinuclear antibodies in mesenchymal scleroderma and progressive systemic sclerosis (author's transl)].
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Lesions of circumscribed scleroderma clinically appeared as pseudoxanthoma elasticum. The histological structure, however, revealed circumscribed scleroderma. The sclerodactyly, Raynaud's phenomenon, acrosclerosis and the laboratory results suggested systemic sclerosis.
An examination of 50 children suffering from various forms of scleroderma revealed clinical signs of nervous system involvement. The data of the skin functional parameters pointed to symptoms of irritation of the sympathetic nervous system. Electroencephalographic and electromyographic changes were observed. On being involved into the pathological process the nervous system begins to participate in the further development of the disease.
A case of disseminated, circumscribed scleroderma with diffuse scleroderma of the acrosclerotic type is reported. The relationship between circumscribed and diffuse scleroderma is discussed. Obstructive changes of peripheral vessels are an early feature of scleroderma.
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A 25 year old suffering from eosinophilic fasciitis is reported. This patient showed periostitis at some bones and myatrophy of thenar and hypothenar besides the typical manifestations related to the involvement of fascia and nearby tissues. On the whole these manifestations reduced the patient's mobility seriously. The typical humoral findings of eosinophilic fasciitis were present, i. e. remarkable eosinophilia, hypergammaglobulinemia with rise of Ig G, and inflammatory serum alterations. Furthermore an increase urinary hydroxyproline excretion was found which means an altered collagen metabolism. This is obviously related to collagen accumulation that in this patient was observed at fascia, perimysium and in the subcutaneous tissue. Ig G deposits were found in the fascia. The reported case raised some problems of differential diagnosis with polymyositis, progressive systemic sclerosis, localized scleroderma and, perhaps, mixed connective tissue disease.
Computer-aided analytical system of TV images (CASTI) of the anterior segment of the eye revealed an appreciable increase of the level of aggregation gradient in arterioles and venules of the bulbar conjunctiva of 37 children suffering from various forms of scleroderma, as against 18 healthy children. Exposure to low-energy laser of a close infrared band (approximately 890 nm) had a favorable impact on blood aggregation in patients with scleroderma. CASTI of the anterior segment of the eye proved to be an objective and highly informative method for the diagnosis and monitoring of the efficacy of various treatment modalities.
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