Nailfold capillaroscopy in systemic sclerosis: is there any difference between videocapillaroscopy and dermatoscopy?

Area of Science:

• Rheumatology
• Dermatology
• Vascular Biology

Background:

• Systemic sclerosis (SSc) is characterized by vasculopathy affecting the nailfold capillary pattern (NCP).
• Dermatoscopy and videocapillaroscopy (VCAP) are common methods for evaluating NCP.
• Previous studies have not compared the diagnostic utility of dermatoscopy and VCAP for SSc.

Purpose of the Study:

• To compare the diagnostic value of dermatoscopy and VCAP in assessing NCP alterations in patients with SSc.
• To determine if dermatoscopy can reliably detect SSc-related NCP changes.

Main Methods:

• Evaluated 382 nailfolds across 39 SSc patients using both dermatoscopy and VCAP.
• Categorized NCP based on dermatoscopic findings and VCAP-determined disease phases (early, active, late).
• Statistically compared the diagnostic concordance between the two methods.

Main Results:

• Both dermatoscopy and VCAP efficiently visualized distinct NCP changes in SSc, including capillary dilatation and disrupted vascularity.
• VCAP identified early, active, and late NCP phases in 20.5%, 46.2%, and 33.3% of patients, respectively.
• A Cohen kappa value of 0.527 indicated moderate agreement; no significant difference in identifying distinct NCP was found between the methods, despite VCAP offering more detailed evaluation.

Conclusions:

• Dermatoscopy is sufficiently effective for identifying pathognomonic NCP changes in SSc, comparable to VCAP.
• Dermatoscopy is a more practical and convenient method for clinical application in SSc NCP assessment.
• While VCAP provides a more detailed analysis, dermatoscopy offers a valuable and accessible alternative for diagnosing SSc vasculopathy.