Question

A 40-year-old female has lost facial wrinkles and presents with extensive dermal fibrosis but almost no inflammatory cell infiltrates in a skin biopsy. These findings are most typical for which of the following conditions?

Answer 1

The description of lost facial wrinkles and extensive dermal fibrosis without significant inflammation in a skin biopsy is characteristic of scleroderma, a chronic systemic autoimmune condition marked by excessive collagen deposition and fibrosis of the skin.

Step-by-step explanation:

The clinical findings of lost facial wrinkles, extensive dermal fibrosis, and a lack of inflammatory cell infiltrates in a skin biopsy are indicative of scleroderma, a chronic systemic autoimmune disease primarily affecting the skin. This condition is characterized by abnormal growth of connective tissue, which leads to the thickening and hardening (fibrosis) of the skin and sometimes other organs. In scleroderma, there is an overproduction of collagen by fibroblasts, which leads to the fibrosis and hardening observed in the skin.

The description given matches the sclerodermatous changes where the skin becomes taut, shiny, and smooth due to the excessive collagen deposition and lack of normal skin structures like hair follicles and sweat glands, as the tissue becomes too fibrous. This condition is quite different from normal inflammatory or scarring processes, where one would expect to find a significant inflammatory response.