QUANTITATIVE NAILFOLD CAPILLAROSCOPY FINDINGS IN A POPULATION WITH CONNECTIVE-TISSUE DISEASE AND IN NORMAL HEALTHY CONTROLS

Objective-To describe and quantify the morphological characteristics o f nailfold capillaries that distinguish different forms of connective tissue disease from healthy controls. Methods-A CCD video microscope w ith fibreoptic illumination and PC based image processing was used to visualise nailfold capillaries findings in 23 patients sclerosis (SSc) , 22 patients with systemic lupus erythematosus (SLE), 21 patients wit h undifferentiated connective tissue disease (UCTD), and 38 healthy co ntrols. Results-Capillary density was reduced in SSc (5.2 (SD 1.3) cap illaries/mm) compared with other patient groups and controls. The aver age number of enlarged capillaries/finger was high in all disease grou ps (5.5-6.6) compared with controls (2). However, giant capillaries we re most frequent in SSc (43%) and were not present in controls. Mild a nd moderate avascular areas were present in all groups (35%-68%), but severe avascularity was most frequent in SSc (44%) compared with other patients (18%-19%) and controls (0%). The greatest frequency of exten sive haemorrhage was in SSc (35%). Conclusions-There is a range of abn ormal capillary findings in patients with connective tissue disease an d healthy controls. However, certain abnormalities such as a reduced n umber of capillaries, severe avascularity, giant capillaries, and haem orrhage are most commonly associated with SSc. Videomicroscopy with im age processing offers many technical advantages that can be exploited in further studies of nailfold capillaries.