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The Unexplored Link between Nailfold Capillaroscopy and Acanthosis Nigricans: A Cross-sectional Clinicodermoscopic
Aditi P Shete1, Bhavana R Doshi2, Manjunath Goroshi3
1Post Graduate Final Year, Department of Dermatology, KAHER's JN Medical College, Bagalkote, Karnataka, India, Orcid: https://orcid.org/0000-0002-4750-7947.
Introduction:
Acanthosis nigricans (AN), a commonly encountered condition in clinical practice, is linked with numerous systemic disorders. Currently, there is a dearth of literature on the correlation of clinical and dermoscopic features of AN with nailfold capillaroscopy (NFC) changes. This study intended to evaluate patients with AN who have underlying microvascular complications as a consequence of metabolic diseases.
Objectives:
Primarily to study the association of clinical and dermoscopic findings of AN with NFC and to elucidate the spectrum of NFC changes in patients of AN.
Materials And Methods:
This was a cross-sectional, hospital-based study with a sample size of 97. Clinical Burke's grading and dermoscopy were performed in clinically diagnosed AN patients. NFC was performed on all 10 fingernails. The fourth and fifth fingernails of each hand were considered for studying the association.
Results:
NFC changes seen were tortuous, dilated, cross-linked, ramified capillaries, and dropouts. There was a positive association of clinical Burke's grading (p-value = 0.002) and duration (p-value = 0.003) of AN with dermoscopic features such as depth of sulci cutis, number of hyperpigmented dots, and shape of papillary projections. Tortuous, cross-linked capillaries showed a significant association with the clinical scale of AN (p-value < 0.05). Ramified and cross-linked capillaries showed a significant association with the duration of AN (p-value < 0.05).
Conclusion:
Dermoscopy in AN showed gradation in changes corresponding to the clinical Burke's grading and duration. Ramified and cross-linked capillaries showed a significant association with the duration of AN, while tortuous, cross-linked capillaries showed a significant association with the clinical scale of AN. The present study aids in the early detection of microvascular changes in AN, such as tortuous, ramified, and cross-linked capillaries, and proves helpful in referring the patient for screening of diabetic retinopathy and nephropathy at the earliest.
