Nail fold capillaroscopy: Normal findings in children and adolescents

Objectives: Capillaroscopy is a simple diagnostic method that permits nonin vasive in vivo study of the capillary network. Studies designed to standard ize capillary normality in children are limited. This article presents the capillaroscopic findings in healthy children and adolescents, thus making t he application of this methodology viable for patients in this age range. Material and Methods: Healthy children were recruited from a private elemen tary school and junior high school. Nail fold capillaroscopy was performed using a stereomicroscope at 16 times magnification, addressing the followin g parameters: capillary morphology, capillary enlargement, devascularizatio n, microhemorrhage, and subpapillary venous plexus visibility (PVS). These parameters were related to age, sex, ethnicity, and local periungal conditi ons. Results: The sample comprised 329 individuals with mean age of 8.2 years. W e observed atypical capillary morphology in 118 of the studied cases (36%), mainly bizarre capillaries in 90 (27%), meandering capillaries in 32 (10%) , and bushy capillaries in 20 (6%). The enlarged capillary phenomenon was u ncommon, being observed in 30 cases (9%). The number of capillaries per mil limeter varied from five to nine. Deletion areas were detected in only seve n individuals (2%). The subpapillary venous plexus was not visualized in 13 (4%) cases. Younger children presented higher PVS scores and fewer capilla ries/mm as compared with older children. PVS scores were lower in males and in nonwhite children. Other variables were not associated with sex or ethn icity. Conclusions: The normal nail fold capillary network in children resembles t hat observed in adults with some differences, such as a lower number of loo ps per millimeter, a higher PVS score, and a higher frequency of atypical l oops. This information is important for the diagnostic evaluation of childr en in the context of autoimmune rheumatic diseases. Semin Arthritis Rheum 2 9:36-42. Copyright (C) 1999 by W.B. Saunders Company.