Title:Nailfold Capillaroscopy Within and Beyond the Scope of Connective Tissue Diseases
Volume: 14
Issue: 1
Author(s): Sevdalina Nikolova Lambova*Ulf Muller-Ladner
Affiliation:
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Kerckhoff Clinic, Bad Nauheim,Germany
Keywords:
Nailfold capillaroscopy, Raynaud's phenomenon, systemic sclerosis, connective tissue disease, rheumatic-like conditions,
diabetic stiff-hand syndrome.
Abstract: Background: Nailfold capillaroscopy is a noninvasive instrumental method for morphological
analysis of the nutritive capillaries in the nailfold area. In rheumatology, it is a method of
choice among instrumental modalities for differential diagnosis between primary and secondary
Raynaud’s phenomenon (RP) in systemic rheumatic diseases. RP is a common diagnostic problem
in rheumatology. Defining the proper diagnosis is a prerequisite for administration of the appropriate
treatment. Thus, nailfold capillaroscopic examination is of crucial importance for the every-day
practice of the rheumatologists and is currently gaining increasing attention. The most specific capillaroscopic
changes are observed in Systemic Sclerosis (SSc). Due to the high prevalence of the
capillaroscopic changes in this clinical entity and their early appearance, they could be used for
early and very early diagnosis of the disease. More recently, “scleroderma” type capillaroscopic
changes have been defined as diagnostic criterion in the new EULAR/ACR classification criteria
for SSc together with the presence of scleroderma-related autoantibodies, RP, telangiectasia and
other clinical signs. Capillaroscopic changes in other connective tissue diseases and in different
rheumatic-like conditions like those in diabetes mellitus (e.g., diabetic stiff-hand syndrome) and
paraneoplastic syndromes associated with microvascular pathology should be interpreted properly
in order to obtain precise diagnosis in the shortest possible differential diagnostic process.
