- Trends of changes in staining extent are shown as ↑↑ (strong increase), ↑ (increase), ↓ (decrease), ↓↓ (strong decrease), 0 (same extent of staining), ~ non-specific fluctuations. Alcian Blue staining of the epidermis was not scored, due to minimal differences in extent of staining that could not be visually assessed. DM1, type 1 diabetes. HC, healthy controls. HME, hereditary multiple exostosis