[Correlation of a quantitative videocapillaroscopic score with the development of digital skin ulcers in scleroderma patients].
BACKGROUND
Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and visceral organs. The microangiopathy is early detectable in the course of the disease by nailfold videocapillaroscopy (NVC), a non-invasive technique with a high diagnostic value.


OBJECTIVE
Aim of our study was to evaluate the feasibility of a quantitative score and its correlation with the digital skin ulcers, which frequently complicate SSc microangiopathy.


METHODS
We retrospectively analysed the NVC of 65 SSc patients, performed by 200x videocapillaroscopy connected to image analyse software (Videocap; DS MediGroup, Milan, Italy). The analysis of NVC images included: total number of capillaries in the distal row (N), maximum diameter (D) and number of giant capillaries (M), M/N ratio and percentage of M, presence/absence of micro-haemorrhages and tortuosity.


RESULTS
21/65 SSc patients experienced digital ulcers within three months after the NVC examination. The N, D, M/N, and percentage of M significantly correlated with the appearance of ischemic ulcers. A multiple regression analysis showed a statistically significant correlation for N, M/N and D, while sensitivity and specificity of these parameters were unsatisfactory. A capillaroscopic score, according to the formula D x M/N2, showed a high specificity and sensibility (93.2% and 85.7% respectively; area under ROC curve: 0.918) to predict the appearance of digital ulcers.


CONCLUSIONS
This capillaroscopic score may represent a feasible and simple tool in SSc patients' assessment. The routinely use of this parameter might permit to recognize and to preventively treat SSc patients at high risk to develop digital ulcers.
Sebastiani
M
M
U.O. e Cattedra Reumatologia, Università degli Studi di Modena e Reggio Emilia.
Manfredi
A
A
Colaci
M
M
Giuggioli
D
D
La Sala
R
R
Elkhaldi
N
N
Antonelli
A
A
Ferri
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002196:Capillaries / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007511:Ischemia / Q000209:etiology; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000473:pathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012883:Skin Ulcer / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D014741:Video Recording
Correlazione di uno score quantitativo capillaroscopico con lo sviluppo di ulcere ischemiche digitali nei pazienti con sclerosi sistemica.