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Skin Histology in Systemic Sclerosis: a Relevant Clinical Biomarker

  • Scleroderma (J Varga, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Systemic sclerosis (SSc) is a life-threatening autoimmune disease that causes debilitating skin fibrosis. The skin in SSc is easily accessible, and skin biopsies may provide rich biological data regarding underlying disease pathophysiology. Here, we review literature relevant to the potential for skin histology to serve as a diagnostic, pharmacokinetic/response, and predictive biomarker in SSc.

Recent Findings

Multiple histologic parameters correlate with SSc severity, including alpha smooth muscle actin (aSMA), CD34, collagen density, thickness, and inflammatory cell infiltration. Recent clinical trials incorporate skin histology as exploratory outcome measurements; however, a standard approach is not yet established. The possibility that skin histology may be useful as a predictive biomarker was suggested by a recent study that identified genes related to skin aSMA and CD34 staining intensity that were increased at baseline among improvers versus nonimprovers.

Summary

Current literature supports skin histology as a mechanism to measure treatment response, but future work is needed to define minimally meaningful changes in key SSc skin histologic features.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Medicine, Division of Rheumatology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Kimberly Showalter & Jessica K. Gordon

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Correspondence to Kimberly Showalter.

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Dr. Showalter reports no disclosures. Dr. Gordon reports receiving funds for the following activities: Research Support: Corbus Pharmaceuticals, Cumberland Pharmaceuticals, and Eicos Sciences, outside the submitted work.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Showalter, K., Gordon, J.K. Skin Histology in Systemic Sclerosis: a Relevant Clinical Biomarker. Curr Rheumatol Rep 23, 3 (2021). https://doi.org/10.1007/s11926-020-00970-z

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