[Vital microscopy of nailfold capillaries in progressive scleroderma in relation to the clinical picture]

Capillary microscopic investigations of the nailfold were performed in 38 patients presenting Raynaud's phenomenon (systemic sclerosis: diffuse type n = 6; systemic sclerosis: CREST syndrome n = 21; Raynaud's disease n = 7; mixed connective tissue disease (MCTD) n = 4). A control group of 15 healthy persons was investigated for comparison. 3 stages of capillary alteration were established in patients with systemic sclerosis by recording number (per 2 mm microscopic field diameter), morphology, colour and size of nailfold capillaries. Additional criteria like pericapillary microhemorrhages and disordered capillary blood flow were considered as well. Significant correlations of capillary microscopie findings to different subsets of systemic sclerosis including MCTD could not be proven. Cases provisionally classified as Raynaud's disease could not be assigned to systemic sclerosis on account of capillary microscopy. A clear correlation was found, however, between the grade of capillary alteration and both severity of clinical features and duration of the disease. All cases with capillary changes of stage 3 showed clinical correlation to esophageal dysmotility , also proven in 7 out of 13 patients with stage 2 capillary alteration.