NAILFOLD CAPILLAROSCOPY IN THE SCREENING AND DIAGNOSIS OF RAYNAUD PHENOMENON

Raynaud's phenomenon is in most cases idiopathic, but it may appear as secondary to other diseases. Since clinical evaluation is often inade quate to distinguish between these two forms, simple noninvasive metho ds are needed for an early diagnosis of the secondary form. The author s used nailfold capillaroscopy to study 58 patients with Raynaud's phe nomenon-44 apparently idiopathic and 14 secondary to connective tissue diseases. In all patients affected by secondary Raynaud's phenomenon nailfold capillaroscopy confirmed the presence of an abnormal pattern with typical systemic sclerosis alterations in 5 cases. Twenty-one (48 %) of the other 44 patients presented a normal capillaroscopic pattern , 15 (34%) had alterations compatible with long-term idiopathic Raynau d's phenomenon, and 8 (18%) showed abnormal capillaroscopic patterns, 2 of which were identified as the sclerodermic pattern. Nailfold capil laroscopy distinguishes between primary and secondary Raynaud's phenom enon and may be used to identify patients presenting no evidence of un derlying disease who could be at risk of developing connective tissue disease.