Nail-fold capillaroscopy for the dermatologists

Grover, Chander; Jakhar, Deepak; Mishra, Arzoo; Singal, Archana

doi:10.25259/ijdvl_514_20

Cited by 14 publications

(3 citation statements)

References 100 publications

(123 reference statements)

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“…We observed a decrease in mean capillary density (4.7 ± 0.81 capillaries/mm) in our study population as compared to normal mean capillary density for healthy subjects (7-14 capillaries/mm). [ 7 ] Jakhar et al . [ 8 ] also observed decrease in mean capillary density (3.57 ± 1.36/mm) among their patients of SSc.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of nailfold capillaroscopy using hand-held dermoscope in systemic sclerosis

Hassan

Jeelani

Bali

et al. 2023

Indian Dermatol Online J

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Introduction: The pathogenesis in systemic sclerosis (SSc) mainly involves vascular injury, fibrosis, and immune activation. Visualization of these microvascular changes by nailfold capillaroscopy (NFC) can help in the early diagnosis of the disease. Even though the gold standard for NFC is a videodermoscope, the ease, practicality, and accessibility make the hand-held dermoscope a more versatile and suitable device in the hands of the dermatologists in the busy outpatient department. Aim: To study the pattern of nail fold capillaries using hand-held dermoscope in the patients of SSc and correlate the findings with disease severity. Materials and Methods: An observational, cross-sectional hospital-based study was carried out over a span of 2 years, from January 2020 till December 2021, in 50 patients of SSc. NFC using DermLite DL4 was performed in all the patients and distribution, morphology, density of capillaries, and nail fold capillary pattern were observed. Results: Out of 50 patients, 38 patients had diffuse type of disease, and 12 had limited type of disease. The mean capillary density in our patients was 4.7 ± 0.81/mm. Dilated capillaries was the most common NFC finding (80%), whereas active scleroderma pattern was the most common pattern (56%). A significant association was found between the type of capillary pattern and duration of disease, type of disease, and cutaneous manifestations. Conclusion: Hand-held dermoscope is reliable, practical, and assessable tool that aids in early diagnosis of the disease and also helps in assessing the severity and prognosis of SSc.

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Section: Discussionmentioning

confidence: 99%

Diagnostic utility of nailfold capillaroscopy using hand-held dermoscope in systemic sclerosis

Hassan

Jeelani

Bali

et al. 2023

Indian Dermatol Online J

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“…Systemic lupus erythematosus nail-fold capillaroscopy alterations have been reported to correspond to disease activity and systemic symptoms [ 25 ]. Furthermore, there is no available information regarding the use of nail-fold capillaroscopy for disorders other than connective tissue diseases in determining disease activity and correlating with other disease-related factors [ 26 ]. The patient was given a treatment with ramipril 2.5 mg daily, verapamil 240 mg daily, mirtazapine 15 mg daily.…”

Section: Discussionmentioning

confidence: 99%

Reversible Cerebral Vasoconstriction Syndrome and Raynaud’s Phenomenon: Is There a Link between the Pathogeneses of Their Underlying Complex Etiology? A Case Report and Literature Review

Alenzi,

D’Cruz

2023

Diagnostics

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Reversible cerebral vasoconstriction syndrome (RCVS) typically manifests as a sudden, severe thunderclap headache due to narrowing of the cerebral arteries. Symptoms usually resolve within three months. An imbalance in cerebral vascular tone, an abnormal endothelial function, and a decreased autoregulation of cerebral blood flow are thought to be involved in the pathogenesis of RCVS. However, the precise origin of this condition is not yet fully understood. Symptoms of Raynaud’s phenomenon (RP) include vasospasm of arterioles of the digits. The pathophysiology of RP includes interactions between the endothelium, smooth muscle, and autonomic and sensory neurons that innervate arteries to help maintain vasomotor homeostasis. RP may occur before the clinical manifestation of a rheumatic condition. RCVS is rare in patients with autoimmune rheumatic disease. We describe a 54-year-old female who had a history of Raynaud’s phenomenon affecting her fingers and toes since the age of 12 years. The patient was diagnosed with RCVS in 2012. She described RCVS precipitants, including the regular use of cannabis, cocaine, and amphetamine and tobacco smoking. In 2021, she presented with oral ulcers, intermittent swallowing difficulties, and Raynaud’s phenomenon. Clinical examination revealed early sclerodactyly, and abnormal nail-fold capillaroscopy showed multiple giant capillaries, dilated capillary loops, and areas of capillary hemorrhage with capillary drop-out. The investigation revealed positive ANA, strongly positive SRP antibodies, and Ro60 antibodies. Our case report indicates that there may be a correlation between RCVS and Raynaud’s phenomenon, and a potential connection between RCVS and autoimmune rheumatic diseases. Hence, physicians must be aware of the red flags and subtle differences in neurological abnormalities, such as headaches, in patients with autoimmune rheumatic diseases who have an inactive clinical status to improve patient care and outcomes.

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“…Grover et al 11 acquired information on microvasculature changes for a disease’s diagnosis and prognosis. Analyses are done on both quantitative factors like mean capillary density and capillary limb width as well as qualitative parameters like morphological or architectural changes, neo-angiogenesis, and the presence or absence of a subpapillary plexus.…”

Section: Introductionmentioning

confidence: 99%

Analysis of microvascular pattern in diabetes mellitus condition using the nailfold capillaroscopy images

Elumalai,

Krishnamoorthi,

Periyasamy

et al. 2024

Proc Inst Mech Eng H

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Diabetes is often considered a vascular disease due to its impact on blood vessels, it is a complex condition with various metabolic and autoimmune factors involved. One of the long term comorbidities of diabetes includes microvascular complications. The microvascular complications can be analyzed using the Nailfold capillaroscopy, a non-invasive technique that allows for the visualization and analysis of capillaries in the proximal nailfold area. Using advanced video capillaroscopy with high magnification, capillary images can be captured from and processed to analyze their morphology. The capillary images of normal group and diabetic group are acquired from 118 participants using nailfold capillaroscopy and the obtained images are preprocessed using image processing filters. The identification and segmentation of the capillaries are the challenges to be addressed in the processing of the images. Hence segmentation of capillaries is done using morphological operations, thresholding and convolutional neural networks. The performance of the filters and segmentation methods are evaluated using Mean Square Error (MSE), Peak signal to Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), Jaccard Index and Sorensen coefficient. By analyzing the morphological features namely the capillary diameter, density, distribution, presence of hemorrhage and the shape of the capillaries from both the groups, the capillary changes associated with diabetic condition were studied. It was found that the non diabetic participants considered in this study has capillary diameter in the range of 8–14 µm and the capillary density in the range of 10–30 capillaries per mm2 whereas the diabetic participants has capillary diameter greater than 30 µm and the capillary density is less than 10 capillaries per mm2. In addition to capillary density and diameter, the presence of hemorrhage, the orientation and distribution of the capillaries are also considered to differentiate the diabetic group from the non diabetic group. The classification of the participants are validated with the clinical history of the participants.

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Nail-fold capillaroscopy for the dermatologists

Cited by 14 publications

References 100 publications

Diagnostic utility of nailfold capillaroscopy using hand-held dermoscope in systemic sclerosis

Diagnostic utility of nailfold capillaroscopy using hand-held dermoscope in systemic sclerosis

Reversible Cerebral Vasoconstriction Syndrome and Raynaud’s Phenomenon: Is There a Link between the Pathogeneses of Their Underlying Complex Etiology? A Case Report and Literature Review

Analysis of microvascular pattern in diabetes mellitus condition using the nailfold capillaroscopy images

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