Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients

Area of Science:

• Rheumatology
• Dermatology
• Vascular Biology

Background:

• Systemic sclerosis (SSc) is characterized by microvascular abnormalities.
• Nailfold videocapillaroscopy (NVC) is a key diagnostic tool for SSc.
• Quantifying microvascular changes in SSc requires standardized methods.

Purpose of the Study:

• To develop and validate a scoring system for capillary abnormalities in SSc using NVC.
• To assess the utility of the scoring system in monitoring microvascular damage progression over time.
• To establish a tool for evaluating therapeutic interventions in SSc.

Main Methods:

• A longitudinal study involving 90 SSc patients over an average of 72 months.
• Evaluation of specific NVC parameters: enlarged/giant capillaries, hemorrhages, capillary loss, disorganization, and ramifications.
• Development of a semiquantitative scoring scale (0-3) for each parameter and a 'microangiopathy evolution score'.

Main Results:

• The capillaroscopic scores significantly changed over the follow-up period.
• The microangiopathy evolution score increased in 59% of patients, indicating worsening vascular damage.
• Improvement in microangiopathy was observed in 24% of patients, while 17% showed no change.

Conclusions:

• The developed capillaroscopic scoring system is sensitive for quantifying and monitoring SSc microvascular damage.
• The microangiopathy evolution score can effectively survey the progression of vascular damage in SSc.
• This scoring system provides a valuable tool for clinical research and patient management in SSc.