Ten-Year Longitudinal Changes in Nailfold Videocapillaroscopy Findings and Clinical Features in Systemic Sclerosis

To investigate whether 10-year changes in nailfold videocapillaroscopy (NVC) findings are associated with changes in clinical characteristics in systemic sclerosis (SSc). This retrospective single-center study included 84 patients with SSc who underwent NVC assessment at baseline and after 10 years. NVC patterns were classified as normal, non-specific, early, active, or late. Patients were categorized by longitudinal NVC changes. Associations of NVC-change groups with changes in clinical characteristics including modified Rodnan skin score (mRSS), digital ulcers, interstitial lung disease, percent predicted vital capacity (%VC), and percent predicted diffusing capacity for carbon monoxide (%DLco) were examined. Over 10 years, NVC findings improved in 19 patients, remained unchanged in 41, and worsened in 24. Change in mRSS differed significantly among the groups, with greater improvement in the improved group than in the unchanged group (p = 0.0140) and the worsened group (p = 0.0161). Changes in digital ulcers were not associated with NVC-change groups. Among 47 patients with longitudinal %DLco data, Δ%DLco differed significantly among the groups, with the greatest decline in the worsened group (p = 0.0067), whereas Δ%VC did not differ significantly. NVC-change group was significantly associated with mRSS at 10 years after adjustment for baseline mRSS and disease duration (p = 0.0291), but not with Δ%DLco after adjustment for interstitial lung disease and pulmonary hypertension at 10 years (p = 0.0684). In conclusion, long-term NVC changes may occur in both directions may reflect the long-term course of skin sclerosis.