LABIAL CAPILLARY MICROSCOPY IN SYSTEMIC-SCLEROSIS

Objectives-To investigate whether in vivo capillary microscopy of the lower lip mucosa can be used to assess microvascular disease in system ic sclerosis. Methods-Thirteen patients with systemic sclerosis and 11 healthy control subjects were studied by conventional nailfold capill ary microscopy and labial capillaroscopy. The following parameters wer e analysed: loop length; loop width (maximum distance between the arte riolar and venular limbs); loop density (number of capillaries/mm2); v enular plexus visibility; megacapillaries; and the architectural arran gement of the capillary network. Results-A typical 'scleroderma patter n' at the nailfold was observed in 12 of 13 (92%) patients with system ic sclerosis. Labial capillaroscopy showed a different morphological p attern of microangiopathy. A diffuse architectural derangement of the capillary network was the most striking abnormality in 12 (92%) patien ts. Labial capillaries in the patients with systemic sclerosis were sh orter (mean (SD) loop length 133 (32.2) mum) than in healthy controls (211 (48.4) mum) and showed an increased loop width (41.7 (13.1) v 27. 6 (5.5) mum in controls. The loop density was 10.5 (4.6) capillaries/m m2 in patients with systemic sclerosis and 9 (1.7) capillaries/mm2 in controls. Labial capillaroscopy in patients with systemic sclerosis di d not provide definite evidence of enlarged capillaries or avascular a reas, or both, even where such abnormalities were clearly evident at t he nailfold. Conclusions-This study shows that labial capillary micros copy is a simple, noninvasive technique which allows a careful morphol ogical assessment of the mucosal microcirculation. Labial capillarosco py in patients with systemic sclerosis showed significant microvascula r changes with respect to the controls. The results of labial and nail fold capillaroscopy are not superimposable, even if some common findin gs, such as architectural derangement, are present.