Capillaroscopic assessment of the nailfold in patients with rosacea

Rosacea is a common chronic inflammatory dermatosis characterized by erythema, papules, pustules, and phymatous lesions in the central facial region. Evidence regarding the pathogenesis of rosacea suggests that microvascular changes may occur in affected individuals. This study aims to examine the relationship between capillaroscopic findings and disease characteristics, subgroups and Demodex infestation.

The study included a patient group of 50 individuals diagnosed with rosacea and a control group of 50 individuals without inflammatory diseases. Capillaroscopic evaluations were performed using a Dino-Lite Edge (P/N: AM7515MZT, Taiwan) digital capillaroscopy device, with the second to fifth nailfolds of both hands examined at ×200 magnification.

The mean age of the patients was 37.6 ± 12.0 years (minimum: 18, maximum: 65), comprising 20 males and 30 females. The capillary density was significantly lower in the rosacea patient group (p = 0.003), whereas the capillary density score was significantly higher in the patient group (p < 0.001). The avascular area and neovascularization rates were also significantly higher in the patient group (p < 0.05). Regular capillary distribution was observed in 50% of the patient group and 81.6% of the control group. The proportion of elongated and tortuous capillaries was significantly higher in the patient group (p = 0.001 and p < 0.001, respectively). Demodex was detected in 70% (n = 35) of rosacea patients. Among the 50 patients, no significant difference was found in Demodex positivity across rosacea subtypes (p = 0.295).

Capillary irregularities, avascular areas, neovascularization, and tortuosity were observed at higher rates in patients with rosacea, suggesting these findings may reflect disease-associated peripheral microvascular alterations.