Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity

Abstract

Our study showed that scleroderma microangiopathy correlates with disease subset and severity of peripheral vascular, skin, heart and lung involvement; patients with late pattern showed an increased risk to have an active disease and to show a moderate/severe skin or visceral involvement compared to patients with early and active patterns. Therefore nailfold videocapillaroscopy, a simple, non-invasive and non-expensive investigation, is useful in staging scleroderma patients and also provides prognostic information.

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

“…In fact, it has long been known that the damaged capillary network in SSc results in micro-vessel abnormalities that can worsen during disease progression (Caramaschi et al, 2007;Cutolo et al, 2004). These observations confirm the results of a recent longitudinal study that reported a dynamic transition of microvascular damage through different capillaroscopy patterns in nearly 50% of SSc patients (Smith et al, 2012;Sulli et al, 2012).…”

“…In order to clarify with further aspects the reported associations between nailfold capillary abnormalities and clinical and/or laboratory features (Bredemeier et al, 2004;Caramaschi et al, 2007;Chen et al, 1984;Cutolo et al, 2004;Hofstee et al, 2009;Lovy et al, 1985;Smith et al, 2012;Sulli et al, 2012) it was decided to evaluate a large multinational group of patients with SSc such as the international multicenter cohort of the EULAR Scleroderma Trials And Research (EUSTAR) registry.…”

Skin Telangiectasia and the Identification of a Subset of Systemic Sclerosis Patients With Severe Vascular Disease

“…Indeed, some studies have shown that the late NVC pattern was predictive of the further development of severe peripheral vasculopathy and pulmonary vascular disease (14,20,21), and Sebastiani et al (22,23) showed that capillary loss, one of the main characteristics of the late NVC pattern, was the most relevant parameter to evaluate the risk of developing new digital ulcers of the capillaroscopic skin ulcer risk index formula.…”

Systemic sclerosis – diagnostic and therapeutic recommendations of the Polish Dermatological Society. Part 1: diagnosis and monitoring

“…Wzór późny rozpoznaje się, gdy w obrazie przeważa dramatyczne (50-70%) zmniejszenie gęstości naczyń z obecnością pól awaskularnych i całkowitą dezorganizacją układu kapilar, które mają charakter naczyń rozgałęzionych i drzewkowatych. Nasilenie zmian w obrazie kapilaroskopowym koreluje ze stopniem zaawansowania choroby zarówno w zakresie zmian skórnych, jak i narządowych oraz może mieć znaczenie prognostyczne [26][27][28]. Sebastiani i wsp.…”