Mdico AnatomoPatologo Universidad Seor de Sipn USS normal synovium normal cartilage ESPONDILITIS ANQUILOPOYETICA ARTRITIS PSORIASICA Artritis psoriasica Artritis psoriasica La Esclerosis Sistmica (esclerodermia) Histopathology of mature scleroderma; full-thickness sclerosis of the dermis. Photomicrograph courtesy of Dirk Elston, MD. ESCLERODERMIA LOCALIZADA In early stages of progressive systemic sclerosis, mucoid changes in the vessel wall predominate, with swollen endothelium and a mucoid appearance of the subintima, frequently with red blood cell fragments, as seen here. (Jones' silver stain, original magnification X400). In the more chronic stage of progressive systemic sclerosis, fibrous organization of the intimal injury results in a lamellated "onion skin" appearance of arteries. (Periodic acid Schiff, original magnification X400). Pathology slides show scleroderma lung and pulmonary arterial hypertension. The gross appearance with lower lobe fibrosis and honeycomb change is identical to that of idiopathic pulmonary fibrosis (A). An artery has medial hypertrophy (M) and intimal hyperplasia (I) (Elastica van Gieson stain, original magnification 100) (B). A vein (V) in the interlobular septum shows marked thickening resulting from intimal hyperplasia (trichrome stain, original magnification 100) (C). (Images courtesy of Dr Michael Fishbein.) Hyperplastic Arteriosclerosis at 40x Magnification -Lung ESCLEROSIS DE LA PARED MUSCULAR ESOFAGICA