Microvascular involvement in systemic sclerosis: capillaroscopic findings.
OBJECTIVE
To show the most representative capillaroscopic findings in patients with systemic sclerosis (SSc).


METHODS
Capillaroscopic evaluation was performed with a videomicroscope at 100 times and 200 times magnification. Representative images of the nailbed 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 changes, 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 areas are the main abnormalities detected in SSc patients.


CONCLUSIONS
Nailfold capillary microscopy is one of the most valuable tools for the early diagnosis of SSc and related disorders. Rheumatologists and internists should be able to recognize these abnormalities because of their diagnostic relevance.
Grassi
W
W
Department of Rhematology, University of Ancona, Italy. reuman@popcsi.unian.it
Medico
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PD
Izzo
F
F
Cervini
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C
D002196:Capillaries / Q000473:pathology; D006801:Humans; D008833:Microcirculation; D018715:Microscopy, Video; D009262:Nails / Q000098:blood supply*; D012016:Reference Values; D012595:Scleroderma, Systemic / Q000473:pathology* / Q000503:physiopathology*