Forearm Skin Capillaries of Diabetic, Potential Diabetic and Nondiabetic Subjects: Changes Seen by Light Microscope

Abstract

Light microscopic examinations were carried out on sections of skin from 30 diabetic and 101 control subjects. Examination of the periodic acid-Schiff stained material in a blind study revealed an abnormality in 16 of the 30 diabetics and 7 of the 101 controls. The abnormality is a hyalinization of the normally fibrillar area external to the endothelial cell of the dermal capillaries. Among the diabetics, the abnormality was seen more frequently in juvenile diabetes, long-standing diabetes, diabetes with retinopathy, neuropathy, or nephropathy, and in obese diabetics. The incidence in control subjects was not strikingly higher in those with a family history of diabetes (3 in 39) or in acromegaly (1 in 11) than in other control subjects (3 in 51). Electron microscopic observations suggest that the lesion may be due to deposition of material in the collagen containing cuff of the capillary wall rather than to basement membrane thickening.