Nailfold Capillaroscopy in the Evaluation of Autoimmune Diseases

Abstract

Introduction: Nailfold capillaroscopy is a simple, safe and
noninvasive method, essential in the evaluation of the microcirculation
in vivo, and crucial to distinguish between
primary or secondary Raynaud’s phenomenon. Raynaud’s
phenomenon assumes its major importance in the spectrum
of systemic sclerosis diseases showing the early involvement
and the vascular changes in the microcirculation
before the onset of other clinical symptoms or organ
involvement, and creating an opportunity to prevent vascular
complications.
Methods: We analyzed, retrospectively, clinical data and
results of nailfold capillaroscopy from 110 patients followed
up at an autoimmune disease consultation, mainly female.
Results: The main reason for performing Nailfold capillaroscopy
was the study of Raynaud’s phenomenon,
mainly secondary cases (67.4%), being the most frequent
underlying pathology the systemic sclerosis. Significant
changes were not found in the capillaries architecture in
27.3% (n = 30). In the remaining, we found minor changes
in 28 cases, presence of megacapillaries in 41 patients
(37.3%), avascular areas in 35 (37.8%), microhemorrhages
in 36 patients (32.7%) and signs of neoangiogenesis in five
(4.5%). The majority of systemic sclerosis patients have
secondary Raynaud’s. Only two patients with systemic
sclerosis did not have a well-defined scleroderma pattern
in the nailfold capillaroscopy.
Conclusion: The nailfold capillaroscopy effectiveness on
early diagnosis of systemic sclerosis, on monitoring disease
progression and in the prediction of organ involvement,
making it an essential noninvasive method, as
supported by its inclusion in the systemic sclerosis classification
criteria.