Nailfold digital capillaroscopic findings in patients with diffuse and limited cutaneous systemic sclerosis

Abstract

BackgroundSystemic sclerosis (SSc) is a chronic disease with microvascular damage. Nailfold capillaroscopy is a non-invasive method used for evaluating capillaries in SSc. Its findings could be related to the internal organ involvement and SSc course. In this study, we aimed to determine the association of the capillaroscopic patterns of nailfold capillaries with the disease subtypes of SSc, disease duration, and clinical manifestations.Material and methodsSeventy patients with SSc (15 cases with diffuse cutaneous SSc [DcSSc] and 55 patients with limited SSc [LcSSc]) were studied. The patients were classified into early and intermediate/late DcSSc and LcSSc regarding their disease duration. The capillaroscopy findings were classified into normal, ‘early’, ‘active’ and ‘late’ scleroderma patterns, and ‘non-specific’ changes. The association of the nailfold capillaroscopy changes and their components with clinical manifestations was also studied.ResultsWe studied 15 DcSSc and 55 LcSSc patients. No association was found between the patterns of capillaroscopic changes and these subtypes. There were 8 early DcSSc, 7 intermediate/late DcSSc, 34 early LcSSc, and 21 intermediate/late LcSSc patients. In patients with LcSSc, the ‘early’ scleroderma pattern of capillaroscopy was associated with early disease based on duration. We found a direct association between some capillary components and some clinical findings. Also, some capillaroscopic components had an inverse association with some clinical manifestations.ConclusionsWe found no association between the patterns of capillaroscopy and SSc subtypes; early scleroderma pattern of capillaroscopy was significantly associated with early LcSSc, compatible with the slower course of the disease in LcSSc. Subtle changes, capillary elongation, and capillary tortuosity had an inverse association with clinical manifestations and might be considered as good prognostic factors.

Assessing nailfold microvascular structure with ultra-wideband raster-scan optoacoustic mesoscopy

“…The technique is widely accepted as a diagnostic tool [ [3] , [4] , [5] ], even forming part of the diagnostic criteria of SSc defined by the American College of Rheumatology and the European League Against Rheumatism [ 6 ]. However, capillaroscopy does not provide detailed images of nailfold microvasculature under certain conditions, such as when the patient's skin around the nail is thick [ 7 , 8 ]. The penetration depth of optical microscopy is limited to approximately 200 μm because tissue strongly scatters light [ 9 ], and penetration is even shallower (few tens of micrometers) for the bright-field microscopy used for capillaroscopy [ 9 ].…”

The comparison of nailfold videocapillaroscopy findings between anti-melanoma differentiation-associated gene 5 antibody and anti-aminoacyl tRNA synthetase antibody in patients with dermatomyositis complicated by interstitial lung disease

“…Capillary loss in NVC findings is observed in the late phase in SSc patients and related to the skin fibrosis progression 16,34 . In the present study, there was a significant positive correlation between the score of capillary loss and the total fibrosis score on chest HRCT findings.…”

Nailfold Capillaroscopy in Rheumatic Diseases

“…Herrick et al found that reduced capillary density was associated with positive anti-centromere antibody [26]. Another study found that anti-centromere was significantly more prevalent in early and active pattern on capillaroscopy than late scleroderma pattern [27]. Most of the other recent studies failed to find significant relationship between ACA positivity and Nailfold Capillaroscopy in Rheumatic Diseases DOI: http://dx.doi.org /10.5772/intechopen.92786 NFC parameters [13,22].…”