The assessment of nailfold capillaries: comparison of dermoscopy and nailfold videocapillaroscopy

Dinsdale, Graham; Peytrignet, Sebastien; Moore, Tonia; Berks, Michael; Roberts, Christopher; Manning, Joanne; Allen, John; Anderson, Marina; Cutolo, Maurizio; Hesselstrand, Roger; Howell, Kevin; Pizzorni, Carmen; Smith, Vanessa; Sulli, Alberto; Wildt, Marie; Taylor, Chris; Murray, Andrea; Herrick, Ariane L.

doi:10.1093/rheumatology/key018

Cited by 20 publications

(17 citation statements)

References 7 publications

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“…Slightly greater than standard (10×) magnification of dermoscopy may improve the visibility of capillary morphology, 3 and now it can be enhanced by smartphones. The majority of dermoscopic pictures (70.9%) remained previously ready for interpretation by expert observers in the study of Dinsdale et al, albeit lower than NVC (79.3%), whereas the specificity of dermoscopy was greater when compared to NVC (92.5% vs. 84.6%) 17 . All healthy controls and patients with primary RP showed no capillaroscopic changes using videodermoscopic evaluation at 30‐fold magnification in the study of Beltran et al.…”

Section: Discussionmentioning

confidence: 94%

“…The majority of dermoscopic pictures (70.9%) remained previously ready for interpretation by expert observers in the study of Dinsdale et al, albeit lower than NVC (79.3%), whereas the specificity of dermoscopy was greater when compared to NVC (92.5% vs. 84.6%). 17 All healthy controls and patients with primary RP showed no capillaroscopic changes using videodermoscopic evaluation at 30‐fold magnification in the study of Beltran et al. The videodermoscopy also showed there a very high specificity (90.9%) in patients observed toward SSc.…”

Section: Discussionmentioning

confidence: 94%

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Role of short courses on nailfold capillaroscopy in obtaining abilities for the identification of microvasculopathy in patients with Raynaud's phenomenon

Miziołek

Pieczyrak

Polak

et al. 2022

Skin Research and Technology

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Introduction An early distinction between “normal” and “abnormal” capillaroscopic pattern during the first visit to a dermatologist has a crucial significance for a diagnostic management of Raynaud's phenomenon (RP). There exists a question about the level of expertise sufficient to evaluate the microcirculation. Aim To evaluate the utility of short courses on NFC among dermatologists and medical students in obtaining sufficient abilities for the identification of microvasculopathy in patients with RP using videocapillaroscope and handheld dermoscope. Methods Both groups participated in 1‐h course on NFC. Before the course, participants were asked to classify 20 videocapillaroscopic and 10 dermoscopic capillaroscopic pictures into “normal” or “abnormal” pattern. Each picture was displayed on a separate slide MS PowerPoint for 10 s. The evaluation was repeated soon after the course. Results A total of 36 dermatologists and 49 medical students were enrolled. The rate of properly classified dermoscopic and videodermoscopic pictures increased after the course in both groups, but students improved the accuracy of classification on dermoscopic pictures to the greater extent than dermatologists. The rate of correctly recognized pictures with “abnormal” pattern was significantly greater than ones with “normal” pattern at the baseline and after the course, independently of imagining tool. Conclusions Short courses on NFC may improve the classification of capillaroscopic images, even in medical staff with no previous experience in NFC. The recognition of capillaroscopic abnormalities seems to be easier than obtaining the confidence that evaluated picture has “normal pattern.”

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Role of short courses on nailfold capillaroscopy in obtaining abilities for the identification of microvasculopathy in patients with Raynaud's phenomenon

Miziołek

Pieczyrak

Polak

et al. 2022

Skin Research and Technology

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“…The dermatoscope compares favourably to nailfold videocapillaroscopy: although as might be expected it is less sensitive in identifying abnormality, it is more specific. 32,33 An ideal solution would be for specialist centres to have access to nailfold videocapillaroscopy, but for all rheumatologists to have at least a low-cost capillaroscopy system, for example, a dermatoscope or USB microscope.…”

Section: Diagnosis and Assessment Of Rpmentioning

confidence: 99%

Raynaud’s phenomenon

Herrick

2019

Journal of Scleroderma and Related Disorders

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Raynaud's phenomenon can be either primary (idiopathic) or secondary to underlying disease including systemic sclerosis. Primary Raynaud's phenomenon is very common, affecting approximately 3%-5% of the general population. Although much rarer, systemic sclerosis-related Raynaud's phenomenon can be particularly severe, progressing to digital ulceration in approximately 50% of patients. Raynaud's phenomenon can have a major impact on quality of life. This review has a focus on the systemic sclerosis-related Raynaud's phenomenon (which is the most researched form of Raynaud's phenomenon and probably the most challenging to treat) and on recent advances. Epidemiology (including transition from 'isolated' to systemic sclerosis-related Raynaud's phenomenon), pathogenesis, diagnosis and assessment are discussed, followed by the treatment of both 'uncomplicated' and 'complicated' Raynaud's phenomena (i.e. Raynaud's phenomenon which has progressed to digital ulceration and/or critical ischaemia). Finally, some of the major challenges for the next 5-10 years are highlighted.

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“…The gold standard technique is videocapillaroscopy (and is the one with which European rheumatologists with an interest in SSc are most familiar [ 7 ]), but this requires expensive equipment and it is unlikely that its use will become widespread among general rheumatologists. Low-cost hand-held microscopes can also visualise the nailfold capillaries; for example, dermoscopy compares favourably to nailfold videocapillaroscopy [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

et al. 2020

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Objectives Universal serial bus (USB) microscopy (capillaroscopy) could provide all rheumatologists with an easy-to-use, low-cost tool to examine the nailfold capillaries to facilitate early diagnosis of SSc. The objectives of this pilot study were to examine the feasibility of acquiring and analysing images using USB microscopy and to compare results to videocapillaroscopy. Methods Videocapillaroscopy and USB microscope images were obtained from the right and left ring fingers of 20 patients with SSc and 20 healthy control subjects. In addition to generating panoramic capillary mosaics from across the whole nailbed, custom software made fully automated measurements of vessel structure including capillary width and density. The area under the receiver operating characteristic curve (AZ) was used to measure separation between the SSc and healthy control groups. Results High quality images could be generated from the USB microscope, with reconstructed USB images comparing very favourably with those obtained using videocapillaroscopy. Using USB microscope images, the receiver operating characteristic curve AZ for group separation based on mean width was 0.81 (standard error 0.120) compared with 0.81 (standard error 0.095) for the (gold standard) videocapillaroscopy. The receiver operating characteristic curve AZ for group separation using capillary density was 0.48 (standard error 0.16) for USB microscope images, compared with 0.70 (standard error 0.10) for videocapillaroscopy. Conclusion In this pilot study, USB capillaroscopy was able to discriminate between patients with SSc and controls as well as videocapillaroscopy on the basis of capillary width. This finding, together with the high-quality images obtained, highlights the potential of USB capillaroscopy as a low-cost, easily accessible clinical and research tool.

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The assessment of nailfold capillaries: comparison of dermoscopy and nailfold videocapillaroscopy

Cited by 20 publications

References 7 publications

Role of short courses on nailfold capillaroscopy in obtaining abilities for the identification of microvasculopathy in patients with Raynaud's phenomenon

Role of short courses on nailfold capillaroscopy in obtaining abilities for the identification of microvasculopathy in patients with Raynaud's phenomenon

Raynaud’s phenomenon

Comparison between low cost USB nailfold capillaroscopy and videocapillaroscopy: a pilot study

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