Capillaroscopic findings in patients with systemic sclerosis and its relationship with clinical manifestations and complementary exams
Keywords:
capillaroscopy, systemic sclerosis, sclerodermiform patternAbstract
Background: systemic sclerosis (SS) is a rare connective tissue disease in which vascular injury and fibrosis are the major mechanisms in its pathogenesis. This can be appreciated on nailfold capillaroscopy.
Objectives: 1. To describe the characteristics of nailfold capillaroscopyin SS patients. 2. To classify them according to the different capillaroscopic patterns. 3. To relate them with clinical manifestations, alterations in the laboratory and other complementary examinations.
Design: cross-sectional descriptive study.
Materials and methods: sixteen patients who fulfilled the ACR/EULAR 2013 criteria for SS were examined. Capillaroscopy images were taken with a handheld dermoscope.
Results: on nailfold images we found enlarged capillaries (100%), microhemorrhages (100%), tortuous capillaries (93,33%), giant capillaries (86,67%), disorganization of the vascular array (80%), capillary loss (40%), avascular areas (46,67%) and bushy capillaries (13,33%). Puffy fingers were associated with enlarged capillaries and avascular areas were associated with sclerodactyly. All patients showed sclerodermiform pattern (SD): initial (53,33%), active (33,33%) or late (13,33%). The active pattern was related to a less than 3 years disease and negative anticentromere antibody; in contrast to the antibody positivity which was associated with the initial pattern. The late pattern was linked to the presence of calcinosis, telangiectasias and a disease of more than 3 years. Bushy capillaries corresponded to the presence of calcinosis and telangiectasias.
Conclusion: we emphasize the role of capillaroscopy as a non invasive tool that allows to estimate the course and prognosis of SS.
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