Moore T L, Vij S, Murray A K, Bhushan M, Griffiths C E M, Herrick A L
Rheumatic Diseases Centre, University of Manchester, Salford Royal NHS Foundation Trust, Salford, UK.
Br J Dermatol. 2009 Apr;160(4):864-7. doi: 10.1111/j.1365-2133.2008.08933.x. Epub 2008 Nov 25.
Little is known about the pathophysiology of localized scleroderma (skin fibrosis, also termed 'morphoea'), although it is likely that microvascular dysfunction is a contributing factor.
Our aim was to investigate different components of blood flow in morphoea using infrared thermography and dual-wavelength laser Doppler imaging (LDI).
Eight plaques of morphoea (in eight patients) were studied. Skin temperature and blood flow were assessed in both affected (within plaque) and adjacent unaffected (perilesional) skin.
Skin temperature (representing blood flow) was higher in all areas of morphoea when compared with uninvolved skin. Perfusion within the plaques was found to be increased, when compared with uninvolved skin; in all cases as imaged by red wavelength (633 nm) LDI (representing blood flow through large, thermoregulatory vessels) and in six of eight cases by green wavelength (532 nm) LDI (representing nutritive capillary blood flow). The median (range) skin temperature difference between plaque and perilesional skin was 1.1 (0.7-2.2) degrees C and the median (range) ratios of plaque/perilesional perfusion as measured by red and green wavelength LDI were 1.3 (1.1-1.9) and 1.1 (0.8-1.5) arbitrary perfusion units, respectively.
Microvascular perfusion is increased within morphoea plaques and the increased response detected by both thermography and red wavelength LDI, as compared with green wavelength LDI, suggests that the increase in perfusion is more marked in deeper, larger, rather than in superficial, smaller vessels.
局限性硬皮病（皮肤纤维化，也称为“硬斑病”）的病理生理学鲜为人知，尽管微血管功能障碍可能是一个促成因素。
我们的目的是使用红外热成像和双波长激光多普勒成像（LDI）研究硬斑病中血流的不同成分。
对8名患者的8块硬斑病斑块进行了研究。在受影响的（斑块内）和相邻未受影响的（病灶周围）皮肤中评估皮肤温度和血流。
与未受累皮肤相比，硬斑病所有区域的皮肤温度（代表血流）均较高。与未受累皮肤相比，发现斑块内的灌注增加；在所有情况下，通过红色波长（633 nm）LDI成像（代表通过大的体温调节血管的血流），在8例中的6例中通过绿色波长（532 nm）LDI成像（代表营养性毛细血管血流）。斑块与病灶周围皮肤之间的皮肤温度差中位数（范围）为1.1（0.7 - 2.2）℃，通过红色和绿色波长LDI测量的斑块/病灶周围灌注的中位数（范围）比率分别为1.3（1.1 - 1.9）和1.1（0.8 - 1.5）任意灌注单位。
硬斑病斑块内微血管灌注增加，与绿色波长LDI相比，热成像和红色波长LDI检测到的反应增加表明，灌注增加在更深、更大的血管中比在浅表、更小的血管中更明显。
