Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed...

Area of Science:

• Rheumatology
• Dermatology
• Microvascular Medicine

Background:

• Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by microvascular abnormalities.
• Nailfold videocapillaroscopy (NVC) is a non-invasive technique to visualize nailfold capillaries and assess microvascular status.
• Distinguishing between limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) is crucial for prognosis and management.

Purpose of the Study:

• To investigate and differentiate detailed nailfold videocapillaroscopy (NVC) findings in patients with limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).
• To correlate NVC findings with disease severity and clinical subsets of systemic sclerosis (SSc).

Main Methods:

• Recruited 157 patients: 100 with lcSSc, 27 with dcSSc, and 30 with primary Raynaud phenomenon (pRP).
• Assessed NVC SSc pattern, absolute capillary number (per linear mm), and scored 'Early'/'Active' and 'Late' NVC status.
• Scoring included capillary dilations, microhemorrhages, giant capillaries, capillary density, altered microvascular architecture, and abnormal capillary shapes.

Main Results:

• Significant differences in absolute capillary number were found across lcSSc, dcSSc, and pRP groups (p<0.001).
• dcSSc patients exhibited significantly higher capillary number loss and a higher 'Late' NVC status score, indicating more severe microvascular damage.
• Higher modified Rodnan Skin Score correlated with decreased capillary number and increased 'Late' NVC status score (p<0.001).

Conclusions:

• Detailed NVC analysis and scoring are essential for differentiating microvascular damage severity between lcSSc and dcSSc.
• The findings highlight NVC's utility in assessing disease severity and progression in systemic sclerosis subtypes.