Nail fold capillaroscopy in leprosy: Unveiling the microvascular changes

Area of Science:

• Dermatology
• Vascular Medicine
• Infectious Diseases

Background:

• Leprosy is a chronic infectious disease linked to nail abnormalities.
• Microvascular damage is a key factor in leprosy's development.
• Nail fold capillaroscopy (NFC) is a novel method for assessing vascular health in leprosy.

Purpose of the Study:

• To characterize nail fold capillaroscopy (NFC) changes in leprosy patients.
• To evaluate NFC as a tool for detecting vascular deficits.
• To correlate NFC findings with leprosy types and reactions.

Main Methods:

• An observational, cross-sectional study of 60 leprosy patients (18-60 years).
• Informed consent, detailed history, and clinical examinations were performed.
• Nail fold capillaroscopy (NFC) was conducted using a video-dermatoscope, with quantitative and qualitative analysis of microvascular changes.

Main Results:

• Microvascular changes detected by NFC in 93.3% of patients.
• Lower capillary density observed in the lepromatous group compared to the tuberculoid group.
• Capillary dropouts, tortuous, and dilated capillaries were common, especially in lepromatous leprosy and Type 2 reactions.

Conclusions:

• NFC changes are common in both tuberculoid and lepromatous leprosy.
• NFC can indicate peripheral vascular compromise and trophic changes.
• NFC serves as a valuable auxiliary tool for identifying microvascular abnormalities in leprosy.