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A list of articles involving FM

Fibromyalgia & Skin Problems

Our skin is in fact the largest organ of our body whose primary function is to act as a protective barrier against foreign invaders. It is made up of two layers, the epidermis and dermis, with a layer of cushioning fat underneath. The epidermis provides an outer protective layer of dead skin cells formed by an active band of cells beneath the surface, that constantly divide and move upwards to replace the dead cells as they are repeatedly brushed away. The next layer, the dermis, consists of collagen fibres and elastin giving strength and flexibility to the skin. It is well supplied with blood vessels, sweat glands, white blood cells and contains millions of tiny nerve endings that relay messages to our brain. It is the hypersensitivity of these nerve endings that is primarily responsible for our abnormal skin sensations.

"Studies show overactive skin pain receptors1," explains Pellegrino. "So the skin can indeed be painful and hurt at the lightest touch. The hypersensitivity of the autonomic nerves result in the symptoms of itching, numbness, tingling, burning and crawling sensations, as well as neurovascular changes leading to cold, dry, sweaty or mottled skin. There is also a phenomenon known as dermatographism where scratching your finger along the skin will cause a raised red mark welt or rash to form,” he adds. “This is most pronounced in the skin overlying painful muscles and thought to be due to dysfunctional autonomic nerves overreacting to the pressure and causing a low-grade skin irritation."

A Swedish study published in 1997 in the Scandinavian Journal of Rheumatology2 also suggests immune system involvement. The researchers took skin biopsies from 25 patients with FM and compared them with healthy controls, patients with rheumatoid arthritis and patients with local chronic pain following whiplash injury. They found that the biopsies from fibromyalgia patients had significantly higher values of immunoglobulin G deposits in the dermis and blood vessel walls and a higher number of mast cells. Mast cells are white blood cells that release histamine, which is known to cause itching, allergies and rashes. Increased mast cell activity indicates that the immune system is overactive and is likely to be adding to the oversensitivity of the skin nerve endings increasing the overall dysfunction of the autonomic nervous system responses.

Mast cells also release another major chemical called heparin, an anticoagulant that thins the blood. "Mast cells release heparin to thin the blood around mosquito bites, for example, so that the swelling doesn't cause a clot," explains Marek. "Increased heparin release from overactive mast cells explains why you see little bruises when you scratch your skin as the capillaries break and leak more easily."

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