Primary pulmonary hypertension is not associated with scleroderma-like changes in nailfold capillaries

Study objectives: To determine whether primary pulmonary hypertension (PPH) is associated with scleroderma-like changes in nailfold capillaries. Design: Blinded, prospective, case-control study. Setting: University medical centers in Baltimore, MD. Patients: Thirty-seven patients with PPH, 15 patients with scleroderma, and 13 healthy control subjects. Measurements: Subjects underwent nailfold capillary videomicroscopy of the fourth digits of both hands. Capillary images were evaluated by two blinded , trained graders according to standardized criteria for the presence of sc leroderma nailfold changes. Results: The prevalence of scleroderma-associated nailfold changes in patie nts with PPH (1 of 37 patients) was dramatically lower than that in patient s with scleroderma (9 of 15 patients; p < 0.0001). The distribution of nail fold grades for the PPH patients was indistinguishable from that of die hea lthy control subjects. Conclusion: PPH is not associated with scleroderma-l ike vasculopathy of nailfold capillaries.