SKIN ABNORMALITIES AND AUTONOMIC INVOLVEMENT IN THE EARLY-STAGE OF AMYOTROPHIC-LATERAL-SCLEROSIS

With the aim to evaluate skin abnormalities in patients affected by am yotrophic lateral sclerosis (ALS) with respect to the dermal ultrastru cture, including autonomic termination, microcirculation and sweat gla nds, 13 ALS patients and 5 controls underwent a skin biopsy of the lef t forearm. Abnormalities of the collagen and elastic fibrils were foun d in 4 and 5 patients respectively; amyelinic axons and sweat glands s howed ultrastructural abnormalities in most ALS patients but not in co ntrols; a quantitative evaluation of the collagen fibrils showed great er diameter of fibrils, larger interfibrillar spaces and more consiste nt size variation in ALS patients than in controls. These results sugg est autonomic involvement in ALS and changes in the collagen fibril or ganization during the early stages of the disease.