Advances in nailfold capillaroscopic analysis in systemic sclerosis.

Area of Science:

• Rheumatology
• Dermatology
• Vascular Biology

Background:

• Systemic sclerosis is an autoimmune disease marked by progressive fibrosis and microvascular damage.
• Microvascular impairment is a key feature, impacting skin and internal organs.
• Assessing peripheral microvasculature is crucial for diagnosis, prognosis, and treatment monitoring.

Purpose of the Study:

• To highlight the importance of morphological and functional assessment of peripheral microvasculature in systemic sclerosis.
• To emphasize nailfold videocapillaroscopy as a validated technique for evaluating microangiopathy in systemic sclerosis.
• To discuss the role of nailfold videocapillaroscopy patterns in classifying scleroderma microangiopathy and their link to clinical manifestations.

Main Methods:

• Utilizing nailfold videocapillaroscopy, a validated technique for peripheral microvascular assessment.
• Classifying and scoring capillary abnormalities into distinct microangiopathy patterns: 'Early', 'Active', and 'Late'.
• Correlating nailfold videocapillaroscopy patterns with clinical manifestations of systemic sclerosis.

Main Results:

• Nailfold videocapillaroscopy effectively detects peripheral microvascular morphology and abnormalities.
• The technique allows for early diagnosis and monitoring of microvascular changes.
• Established links exist between specific nailfold videocapillaroscopy patterns and systemic sclerosis clinical features.

Conclusions:

• Nailfold videocapillaroscopy is a safe and essential tool for evaluating systemic sclerosis patients.
• Its ability to diagnose, classify, and monitor microvascular changes supports its inclusion in classification criteria.
• Understanding nailfold videocapillaroscopy patterns aids in managing systemic sclerosis and predicting outcomes.