Development of severe limited scleroderma in complicated Raynaud's phenomenon after limb immobilization: Report of two cases and study of collagen biosynthesis

We describe 2 patients with Raynaud's phenomenon who developed severe sclerodermatous changes after immobilization. The scleroderma was confined to the immobilized limb. Histologic examination of tissue samples of the affected skin showed mononuclear cell infiltrates and marked collagen deposition in the dermis and subcutaneous adipose tissue. In vitro biosynthetic studies demonstrated a dramatic increase in collagen production by cultures of involved skin from one of the patients. These results suggest that immobilization resulted in activation of dermal fibroblasts (perhaps mediated by inflammatory cells) and in the subsequent development of fibrosis in both of these patients.