Capillaroscopic Pattern at the Toes of Systemic Sclerosis Patients

Lambova, Sevdalina Nikolova; Hermann, W.; Müller‐Ladner, Ulf

doi:10.1097/rhu.0b013e31822be4e8

Cited by 32 publications

(28 citation statements)

References 8 publications

(4 reference statements)

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“…However, concerns about the reproducibility of thermography have limited its use (4). As RP affects both hands and feet (5, 6) we used infrared thermography to measure skin temperature differences between the palm of the hand and the fingers and between the dorsum of the feet and the toes in patients with RP and normal healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Digital Thermography of the Fingers and Toes in Raynaud's Phenomenon

et al. 2014

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The aim of this study was to determine whether skin temperature measurement by digital thermography on hands and feet is useful for diagnosis of Raynaud's phenomenon (RP). Fifty-seven patients with RP (primary RP, n = 33; secondary RP, n = 24) and 146 healthy volunteers were recruited. After acclimation to room temperature for 30 min, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. Temperature differences between palm (center) and the coolest finger and temperature differences between foot dorsum (center) and first toe significantly differed between patients and controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2.2℃) differentiated RP patients from controls (sensitivity/specificity: 67/60%, respectively). Temperature differences of first toe (cutoff value: 3.11℃) also discriminated RP patients (sensitivity/specificity: about 73/66%, respectively). A combination of thermographic assessment of the coolest finger and first toe was highly effective in men (sensitivity/specificity : about 88/60%, respectively) while thermographic assessment of first toe was solely sufficient for women (sensitivity/specificity: about 74/68%, respectively). Thermographic assessment of the coolest finger and first toe is useful for diagnosing RP. In women, thermography of first toe is highly recommended.Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Digital Thermography of the Fingers and Toes in Raynaud's Phenomenon

et al. 2014

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“…Considering the strong diagnostic potential of nailfold capillaroscopy in SSc, we have previously studied nailfold capillaroscopic changes of the toes in a group of 36 SSc patients. Interestingly, whereas in the fingers, a “scleroderma” type capillaroscopic pattern has been found in 97.2% (35/36) of patients, in the toes, it has been detected in only 66.7% (24/36) of cases ( P < .05) . On the one hand this observation confirms the generalized nature of microangiopathy in SSc; on the other hand, the significantly lower frequency of the “scleroderma” type capillaroscopic pattern of the toes indicates the diversity of the capillaroscopic findings in different nailfold areas.…”

Section: Introductionmentioning

confidence: 72%

Inhomogeneity of capillaroscopic findings in systemic sclerosis

Lambova

Müller‐Ladner

2019

Int J of Rheum Dis

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Background Despite the great interest in capillaroscopy in systemic sclerosis (SSc), research on the possible combinations of different microvascular phenomena at different fingers in SSc patients have not been performed until now. Objective To assess the diversity of capillaroscopic findings in SSc. Methods The study includes analysis of the capillaroscopic findings in 40 SSc patients who were divided into the following categories: “scleroderma”, type pattern ‐ “early”, “active”, “late” phase, normal and/or nonspecific findings. The data were analyzed using descriptive statistics and t test. Results In 77% of the patients, inhomogeneity of the capillaroscopic findings of the fingers was detected. The most frequent combinations of capillaroscopic patterns were “early + active” (n = 7), “active + late” phase (n = 7), “active” phase + normal and/or nonspecific findings (n = 6), “early + active” phase + normal and/or nonspecific findings (n = 4). Concomitant presence of normal and/or nonspecific findings and “late” phase was detected in only 3 cases. Conclusion Inhomogeneity of the capillaroscopic findings in SSc is a frequent phenomenon. The results indicate that combinations of “scleroderma” type capillaroscopic findings from different phases could be observed as well as concomitant appearance of pathological and normal/or nonspecific findings of different digits. This phenomenon could be a result of the complex action of different factors eg, disease duration, severity of Raynaud's phenomenon, presence of digital ulcers, local action of different angiogenic and angiostatic factors, gradual transition from one phase to another due to the extensive capillary area, therapeutic interventions.

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“…Here a distinct discrepancy to other study results is seen. Lambova et al examined the toes of 36 patients with SSc and found megacapillaries in 11 patients, hemorrhages in 3 and avascular areas in 15. The reason for this discrepancy might be the different patient collectives.…”

Section: Discussionmentioning

confidence: 99%