Microvascular involvement in systemic sclerosis: Capillaroscopic findings

Objective: To show the most representative capillaroscopic findings in pati ents with systemic sclerosis (SSc). Methods: Capillaroscopic evaluation was performed with a videomicroscope at 100 times and 200 times magnification. Representative images of the nailbe d microcirculation were obtained in 20 healthy subjects and in 75 patients with SSc. Results: Capillary abnormalities were seen at the nailfold in more than 90% of patients with SSc. Capillary involvement included several morphologic c hanges, which are easily distinguished from the pattern of healthy controls . Architectural disruption of the nailfold microvascular network, enlarged loops, neoformation of capillaries, loss of capillaries, and avascular area s are the main abnormalities detected in SSc patients, Conclusions: Nailfold capillary microscopy is one of the most valuable tool s for the early diagnosis of SSc and related disorders. Rheumatologists and internists should be able to recognize these abnormalities because of thei r diagnostic relevance. Semin Arthritis Rheum 30:397-402, Copyright (C) 2007 by W.B. Saunders Compa ny.