Stereological analysis of collagen and elastic fibers in the normal human dermis: Variability with age, sex, and body region

Normal human dermis has been analyzed using stereological methods to estimate the quantitative modifications of collagen and elastic fibers in relation to age, sex, and body region. Forty-five skin biopsies from the trunk or the limbs of 26 males and 19 females of different age were fixed in glutaraldehyde and osmium tetroxide and embedded in epoxy resin. The relative volumes of collagen and elastic fibers were calculated by the point counting method on 1 mu m semithin sections. Photographic sampling was performed on four consecutive dermis layers: the papillary layer and three consecutive layers of reticular dermis. The data were subjected to analysis of variance which showed that all the factors studied exert a significant influence on the relative amounts of collagen and elastic fibers. The fractional volume of collagen fibers is constant throughout all dermis layers analyzed and is always higher in females than in males, except for the second and third decades of life. Collagen fiber density increases with age in both sexes up to 30-40 years, when it starts decreasing. Both the relative volumes and the diameters of elastic fibers increase from papillary to deep reticular dermis. In reticular dermis of both sexes there is an increment of elastic fiber density in the first decade of life, followed by a drop particularly marked in males. After 20 years, the relative volume of elastic fibers displays a decreasing trend in females, whereas it increases in males,attaining the highest values beyond the 40s.