Capillary abnormalities, Raynaud's phenomenon, and systemic sclerosis in patients with localized scleroderma

Area of Science:

• Dermatology
• Rheumatology
• Vascular Biology

Background:

• Localized scleroderma is a distinct condition from systemic sclerosis.
• Nailfold capillaroscopy is a key diagnostic tool for systemic sclerosis, revealing characteristic microvascular changes.
• The presence of these changes in localized scleroderma is not well-established.

Purpose of the Study:

• To investigate the prevalence of systemic sclerosis-like nailfold capillary abnormalities in patients with localized scleroderma.
• To assess the diagnostic significance of such findings in differentiating or identifying coexisting systemic sclerosis.

Main Methods:

• In vivo capillaroscopy was utilized to examine the nailfold capillaries of 27 patients diagnosed with localized scleroderma.
• Patient data, including clinical presentation and follow-up, were analyzed.

Main Results:

• Only two out of 27 patients (7.4%) displayed nailfold capillary abnormalities typical of systemic sclerosis.
• Both patients with these abnormalities also had Raynaud's phenomenon and were later diagnosed with or showed evidence of systemic sclerosis.
• These findings suggest a rare but significant overlap between the two conditions.

Conclusions:

• The identification of systemic sclerosis-like nailfold capillary abnormalities in localized scleroderma patients is a critical alert for potential concurrent systemic sclerosis.
• Physicians should consider further investigation for systemic sclerosis in such cases.
• Capillaroscopy remains valuable in the differential diagnosis and management of scleroderma spectrum disorders.