Table 1

Grading of dermal fibrosis in systemic sclerosis

Dermal fibrosis gradeDescription
No homogenization but there may be atrophic, thin straightened collagen bundles with increased amounts of interstitial ground substance 
Less than 25% sclerosis with residual foci; some residual straightening or eosinophilic collagen bundles may be present 
Focal sclerosis—less than 50% overall 
Incomplete homogenization with spaces between the collagen bundles with 50% to 75% sclerotic change 
Pandermal sclerosis without obvious expansion of the lower reticular dermis with some sparing of perieccrine adipose tissue 
Pandermal sclerosis with homogenization from the papillary to the reticular dermis; includes obvious widening of the reticular dermis below the eccrine coils with extension into the hypodermis and formation of fibrous septa 
Dermal fibrosis gradeDescription
No homogenization but there may be atrophic, thin straightened collagen bundles with increased amounts of interstitial ground substance 
Less than 25% sclerosis with residual foci; some residual straightening or eosinophilic collagen bundles may be present 
Focal sclerosis—less than 50% overall 
Incomplete homogenization with spaces between the collagen bundles with 50% to 75% sclerotic change 
Pandermal sclerosis without obvious expansion of the lower reticular dermis with some sparing of perieccrine adipose tissue 
Pandermal sclerosis with homogenization from the papillary to the reticular dermis; includes obvious widening of the reticular dermis below the eccrine coils with extension into the hypodermis and formation of fibrous septa 

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