Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis

Objective. To correlate microvascular abnormalities, evaluated by nailfold videocapillaroscopy (NVC), with the duration of both Raynaud's phenomenon ( RP) and systemic sclerosis (SSc) from the date of diagnosis, in a large num ber of patients with SSc. Methods. Ninety-seven consecutive patients were recruited and distributed i nto 3 groups on the basis of the morphological NVC patterns observed: "earl y" (E), "active" (A), and "late" (L). In each group the age of patients, ag e at onset, and the duration of RP as well as of overt SSc were investigate d and correlated with the different NVC pattern variables. Results, The early appearance of giant capillaries and hemorrhages (E patte rn) is of great relevance for the early diagnosis of SSc, Therefore, these alterations are more evident in the active phase of the disease (A pattern) . Conversely, the NVC observation of loss of capillaries and vascular archi tectural disorganization and the presence of ramified/bushy capillaries (L pattern) represents the dearest aspect of advanced SSc microvascular damage . These morphological alterations were found to correlate significantly wit h the duration of both RP and SSc, as well as with age of patients (p = 0.0 001). No significant differences were observed when the variables were anal yzed in the patients classified as having limited cutaneous SSc or diffuse cutaneous SSc. Conclusion. Classification of defined major nailfold patterns may-be useful in assessing the appearance and progression of sclerodermic microangiopath y, As well, nailfold changes might represent a morphological reproduction o f the evolution of SSc.