ISSN: 2041-6792

Clinical Investigation

Medical-journals In Histology

Histological studies have been used to investigate the biological processes at work in the skin in chronic venous disease. A quantitative histological study has been reported in which three groups of patients was studied. The first was a group of patients with no evidence of skin changes as a consequence of their venous disease. The next group exhibited lipodermatosclerosis without a history of ulceration. The third group had healed ulcers with residual lipodermatosclerosis. Patients with normal skin had a low number of white blood cells visible (4 per mm2) in the upper 0.5 mm of the skin. There were eight times as many in patients with lip sclerotic skin, and 40 times as many in patients with healed venous ulcers. Subsequently an immunohistological study was undertaken to determine the types of white cell present in this infiltrate. The majority of cells are macrophages with a T-lymphocyte component, but no excess of neutrophils compared with control sections taken from normal limbs. So this infiltrate is a reflection of a chronic inflammatory process. Histology remains the strongest predictor of outcome. In particular, anaplasia, defined by cells showing irregular mitosis, enlarged nuclei, and hyperchromasia, portends a poorer outcome compared with favorable-histology (standard triphasic) tumors. Anaplasia is subdivided further into diffuse or focal categories.  

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