Early stages of the disease show superficial and deep inflammatory cellular infiltrate in the dermis.

The moderately dense infiltrate is composed of lymphocytes and some histiocytes and plasma cells.

Prominent vascular channels together with telangiectasia may be present.

In some cases there is a superficial band-like infiltrate of inflammatory cells with subepithelial thin zone of collagen.

Vacuoles are sometimes noted in the upper dermis.

As the disease progresses there is atrophy of the dermis together with loss of elastic fibers and pilosebaceous  follicles and atrophy of subcutis.

Other changes include epidermal atrophy and loss of rete ridges, features resembling lichen sclerosus et atrophicus.

In the sclerodermatous patches are characterized by dense dermal sclerosis.

This process can be told to be active by the density of the lymphoplasmacytic infiltrate and can be considered to be long standing by the extent of fibroplasia, thick collagen bundles being aligned mostly parallel to the skin surface, sclerosis being evident in the deep reticular dermis, and telangiectases being prominent in the upper part of the dermis.

Juxtra-articular fibrous nodules are characterized by broad bundles of homogeneous collagen in the upper subcutis.

Perivascular and interstitial inflammatory infiltrate is present.