Vol 9, No 1 (2023)
Review paper
Published online: 2023-03-21

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Capillaroscopic examination in the early diagnosis of systemic sclerosis

Ewa Wielosz1
Rheumatology Forum 2023;9(1):11-13.

Abstract

Systemic sclerosis (SSc) is a connective tissue disease characterised by impairment of vascular function. One of the examinations particularly useful in the early diagnosis of SSc is nail fold capillaroscopy. In SSc, the capillaroscopic findings show characteristic microcirculatory disorders defined as SSc-associated microangiopathy. The term microangiopathy includes the following pathological changes: decreased numbers of vessels with areas of avascularisation, widened vascular loops leading to the formation of megacapillaries, the presence of ramified loops and cap-shaped microextravasations. The important pathological changes occurring already in the early forms of SSc are megacapillaries Apart from early diagnosis, capillaroscopy is of prognostic importance, as the type of capillaroscopic lesions may correlate with disease activity and the degree of involvement of internal organs. In addition, capillaroscopy is used to monitor the course of SSc and the response to treatment.

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References

  1. Lescoat A, Lecureur V, Varga J. Contribution of monocytes and macrophages to the pathogenesis of systemic sclerosis: recent insights and therapeutic implications. Curr Opin Rheumatol. 2021; 33(6): 463–470.
  2. Maciejewska M, Sikora M, Maciejewski C, et al. Raynaud's phenomenon with focus on systemic sclerosis. J Clin Med. 2022; 11(9): 2490.
  3. Sakamoto T, Kaburaki M, Shimizu T. Nailfold capillaroscopy findings and systemic sclerosis. QJM. 2022; 115(4): 266.
  4. Lambova SN, Kurteva EK, Dzhambazova SS, et al. Capillaroscopy and immunological profile in systemic sclerosis. Life (Basel). 2022; 12(4): 498.
  5. Smith V, Herrick AL, Ingegnoli F, et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis. Autoimmun Rev. 2020; 19(3): 102458.
  6. Matucci-Cerinic M, Bellando-Randone S, Lepri G, et al. Very early versus early disease: the evolving definition of the 'many faces' of systemic sclerosis. Ann Rheum Dis. 2013; 72(3): 319–321.
  7. Cutolo M, Sulii A, Pizzorni C, et al. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000; 27: 155–160.
  8. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2013; 72(11): 1747–1755.
  9. Boulon C, Velardo F, Blaise S, et al. Correlation of nailfold capillaroscopy findings with history of digital ulcer on same finger: Results of SCLEROCAP study. Microvasc Res. 2022; 142: 104365.
  10. Minopoulou I, Theodorakopoulou M, Boutou A, et al. Nailfold capillaroscopy in systemic sclerosis patients with and without pulmonary arterial hypertension: a systematic review and meta-analysis. J Clin Med. 2021; 10(7): 1528.
  11. Sánchez-Cano D, Ortego-Centeno N, Callejas JL, et al. Interstitial lung disease in systemic sclerosis: data from the Spanish scleroderma study group. Rheumatol Int. 2018; 38(3): 363–374.
  12. Faggioli P, Giani L, Mazzone A. Possibile role of iloprost (stable analogue of PGI2) in promoting neoangiogenesis in systemic sclerosis. Clin Exp Rheumatol. 2006; 24(2): 220–221.