Clinical utility of nailfold capillaroscopy

Area of Science:

• Rheumatology
• Dermatology
• Immunology
• Microvascular Medicine

Background:

• Nailfold capillaroscopy (NFC) is a noninvasive technique for examining nailfold capillaries.
• Microvasculopathy in nailfold capillaries is crucial in scleroderma spectrum disorders, including dermatomyositis and antisynthetase myositis.
• Current understanding of the microvasculopathy's cause is limited, but it's linked to Raynaud Phenomena and autoantibodies.

Purpose of the Study:

• To review methodologies and diagnostic utility of nailfold capillaroscopy (NFC).
• To discuss recent advances in analyzing microvascular patterns and metrics.
• To explore the potential of NFC as a biomarker for managing scleroderma spectrum disorders.

Main Methods:

• Review of existing literature on nailfold capillaroscopy (NFC) techniques.
• Discussion of diagnostic applications using bedside equipment (ophthalmoscope, dermatoscope, smartphone).
• Analysis of recent advancements in reporting abnormal microvascular patterns and vascular metrics like capillary density and dropout.

Main Results:

• NFC is a valuable diagnostic tool for identifying microvasculopathy in scleroderma spectrum disorders.
• Simple bedside techniques provide significant diagnostic utility.
• Advances enable detailed reporting of abnormal microvascular patterns and quantitative vascular metrics.

Conclusions:

• Nailfold capillaroscopy (NFC) offers a clinically accessible view into the pathology of scleroderma-related diseases.
• Wider availability of NFC is recommended in rheumatological, immunological, and dermatological practices.
• NFC shows promise as a future biomarker for managing scleroderma spectrum disorders.