Clinical implications from capillaroscopic analysis in patients with Raynaud's phenomenon and systemic sclerosis

Herrick, Ariane L.; Cutolo, Maurizio

doi:10.1002/art.27543

Cited by 93 publications

(69 citation statements)

References 76 publications

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“…SSc has a heterogeneous clinical presentation, but skin and vascular changes are the hallmark of the disease (Geyer and MullerLadner, 2011;Herrick, 2012). Pathological microvascular findings in SSc document a significant loss of the peripheral vascular network, with loss of capillaries, deficient vascular repair and the absence of new vessel growth, and subsequent tissue ischemia and fibrosis (Brown and O'Leary, 1925;Herrick and Cutolo, 2010;Kuwana et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…Capillaroscopy is a powerful in vivo tool not only in screening patients with Raynaud's phenomenon for underlying scleroderma spectrum disorders (Ingegnoli et al, 2008(Ingegnoli et al, , 2010Nagy and Czirjak, 2004;Vayssairat et al, 1982), but also in detecting the progressive microvascular damage during the course of SSc (Herrick and Cutolo, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…The distinctive and identifiable morphological nailfold changes observed in patients with SSc have been extensively studied; they include enlarged loops, giant capillaries, neovascularization, capillary loss, and disrupted architecture of the nailfold microvascular network (Bukhari et al, 1996;Herrick and Cutolo, 2010;Maricq and LeRoy, 1973;Maricq et al, 1980Maricq et al, , 1983. These microvascular scleroderma specific capillaroscopy abnormalities were initially described by Maricq (Maricq et al, 1980(Maricq et al, , 1983 and called "scleroderma patterns"; subsequently they were classified into 3 different patterns, which include an "early" pattern (i.e.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nailfold capillaroscopy in systemic sclerosis: Data from the EULAR scleroderma trials and research (EUSTAR) database

Ingegnoli

Ardoino

Boracchi

et al. 2013

Microvascular Research

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103

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nailfold capillaroscopy in systemic sclerosis: Data from the EULAR scleroderma trials and research (EUSTAR) database

Ingegnoli

Ardoino

Boracchi

et al. 2013

Microvascular Research

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103

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“…[13][14][15][16] In scleroderma, NFC findings can actually correlate with the early, active or late stages of the disease. 12 Whereas, in disorders like scleroderma, MCTD, dermatomyositis etc these abnormalities can predict pulmonary involvement.…”

Section: Binit Vaidya Et Al Nfc Findings In Raynaud's Phenomenon | mentioning

confidence: 99%

Nailfold capillaroscopic findings in patients with Raynaud’s phenomenon: Preliminary report

Vaidya

Bhochhibhoya

2015

J Adv Intern Med

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Back grounds and Aims: Microvascular involvement of nailfold often occurs in systemic rheumatic diseases, especially scleroderma and related conditions. Nailfold capillaroscopy is easily performed non-invasive, simple, repeatable, sensitive, safe and inexpensive method to examine nailfold architecture by microscope.The normal capillaries are thin, symmetrical and have hair-pin appearance. Anomalies include dilated capillary loops, dropouts, tortuosity, avascular area, arborifications, megacapillaries, infracts,thrombsis and haemorrhages. This study aims to see the morphological changes in microcirculation in nailfolds of patients with Raynaud’s, which can be helpful in predicting the presence of connective tissue disorder.Methods: It is an observational study conducted at National Center for Rheumatic Diseases, Kathmandu from 26th March 2014 to 30th March 2015. Nailfolds of 8 fingers of both hands in 105 patients were examined using a hand held microscope.Results: Of 105 patients, 91 patients (86.6%) had abnormal morphological changes while 14 (13.4%) had no significant changes in microvessels. Normal patients had no underlying connective tissue disease(CTD) but those with abnormal findings had proven underlying CTD which included Lupus 6.5%, Scleroderma 17.5%, Rheumatoid Arthritis 14.2%, Mixed CTD7.6%, Undifferentiated CTD1.0%, Undifferentiated inflammatory arthritis 14.2%, Psorasis 1.0%, Rheumatoid Arthritis with scleroderma overlap 4.3%. No primary diagnosis was found in 32.9% of patients.Conclusion: Nailfold capillaroscopy allows direct examination of microvascular structure of a patient. Abnormal findings in a patient with Raynaud’s phenomenon might help to identify the presence of or future evolution into systemic connective tissue disorder.Journal of Advances in Internal Medicine 2015;04(01):13-15

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“…[14][15][16] Presently, abnormal capillaroscopy is not only considered a diagnostic criterion for the very early diagnosis of SSc, 17 but also provides prognostic clinical information as it is linked to important microvascular complications in SSc. [18][19][20][21] Microvascular injury is an early event and generally precedes fibrosis in SSc, 15,22,23 and in cGVHD patients early detection of capillary abnormalities by a non-invasive method might identify those at risk of sclerodermatous development. Whether microvascular changes that can be visualised in SSc are also present in sclerodermatous cGVHD remains to be demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Nailfold capillary abnormalities in sclerodermatous chronic GVHD

Hofstee

Waal

Voskuyl

et al. 2013

Bone Marrow Transplant

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Chronic GVHD (cGVHD) complicating allo-SCT commonly presents as sclerotic skin changes resembling systemic sclerosis (SSc), suggesting a common pathophysiological pathway. Damage to capillaries is considered an early event in the pathogenesis of SSc, and is associated with characteristic nailfold capillary abnormalities. Whether such nailfold capillary abnormalities occur in sclerodermatous cGVHD is unknown. Nailfold videocapillaroscopy (NVC) was used to evaluate capillary morphology, density and loop dimensions in 14 patients with sclerodermatous cGVHD, 14 sex-and age-matched SSc patients, and 14 healthy controls. It was shown that none of the cGVHD patients and controls, whereas all SSc patients showed severe capillary abnormalities. cGVHD patients and controls showed no differences in capillary density (9.05 vs 9.16 loops/mm, respectively, P ¼ 0.84), and capillary loop dimensions (total loop width 44.36 vs 45.56 mm, respectively, P ¼ 0.84). Compared with cGVHD patients, SSc patients had a reduced capillary density (9.05 vs 5.25 loops/mm, respectively, Po0.001), and an increase in capillary loop dimensions (total loop width 44.36 vs 99.97 mm, respectively, P ¼ o0.001). In conclusion sclerodermatous cGVHD patients do not show the characteristic microvascular abnormalities seen in SSc, suggesting that capillary damage does not contribute to the pathophysiology of sclerodermatous cGVHD, and making NVC unsuitable for early identification.

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Clinical implications from capillaroscopic analysis in patients with Raynaud's phenomenon and systemic sclerosis

Cited by 93 publications

References 76 publications

Nailfold capillaroscopy in systemic sclerosis: Data from the EULAR scleroderma trials and research (EUSTAR) database

Nailfold capillaroscopy in systemic sclerosis: Data from the EULAR scleroderma trials and research (EUSTAR) database

Nailfold capillaroscopic findings in patients with Raynaud’s phenomenon: Preliminary report

Nailfold capillary abnormalities in sclerodermatous chronic GVHD

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