<prompt> Answer this question truthfullyWhat is the underlying physiological mechanism of scleroderma?  <response>: <reason> On microscopic histopathological analysis characteristic findings of scleroderma include: Microvascular damage Arterioles are primarily affected Perivascular edema Large gaps between endothelial cells Loss of integrity of the endothelial lining Platelet aggregation in the vessels Vacuolization of the cytoplasm of endothelial cells Perivascular infiltrates of mononuclear immune cells in the walls of arterioles Obliterative microvascular lesions Rarefaction of capillaries Small vessel effacement Fibrosis Densely packed collagen in the lower dermis Upper subcutaneous layer also affected Loss of reticular structure Accumulation of proteoglycans, fibrillar and elastic fibers Accumulation of type I collagen Atrophy and loss of cells in later stages 