[Indications for nailbed capillaroscopy in Raynaud's phenomenon]

Area of Science:

• Rheumatology
• Dermatology
• Vascular Medicine

Context:

• Raynaud's phenomenon affects numerous patients, necessitating accurate diagnostic tools.
• Differentiating primary Raynaud's disease from secondary causes, particularly connective tissue diseases, is clinically significant.
• Nailfold capillaroscopy is a non-invasive bedside technique for microvascular assessment.

Purpose:

• To evaluate the utility of nailfold capillaroscopy in diagnosing Raynaud's phenomenon.
• To assess the correlation between capillaroscopic findings and underlying etiologies.
• To propose a simplified classification for interpreting capillaroscopic results.

Summary:

• 175 patients with Raynaud's phenomenon underwent nailfold capillaroscopy.
• Normal capillaroscopy is consistent with idiopathic Raynaud's disease.
• Pathological findings, including megacapillaries, suggest connective tissue disease or other secondary causes.
• A simplified classification demonstrated good diagnostic discrimination.
• Abnormal capillaroscopy probability increases with age of onset but is also observed in younger patients.
• Allen's criterion was found to be disappointing and should be reconsidered.

Impact:

• Nailfold capillaroscopy provides valuable diagnostic information for Raynaud's phenomenon across all age groups.
• The findings support the use of nailfold capillaroscopy as a key diagnostic tool in clinical practice.
• This study aids in refining diagnostic criteria and improving patient management for Raynaud's phenomenon.