Nailfold capillaroscopy in myositis: A case series

Nailfold capillaroscopy is well established in systemic sclerosis; however, abnormalities (scleroderma or scleroderma-like patterns) are identified in other connective tissue diseases, such as myositis, even in the absence of Raynaud's phenomenon. Although this may be known within the rheumatology world, myositis cases often present to other subspecialists who may be unfamiliar with the value of capillaroscopy. We present four cases of myositis that initially presented to non-rheumatology subspecialists where capillaroscopy played a role in confirming the diagnosis. Nailfold capillaroscopy is especially useful in cases of isolated interstitial lung disease, atypical and isolated rashes, and to delineate between myositis mimickers, whether pathologic or clinical. It is a noninvasive tool, which is useful early in the work-up of myositis to identify features consistent with a connective tissue disease.