title: A portable dermatoscope for easy, rapid examination of periungual nailfold capillary changes in patients with systemic sclerosis.
abstract: Microvascular lesions are a predominant feature in systemic sclerosis (SSc) and seem to play a central pathogenic role. The presence of nailfold capillary abnormalities is useful in diagnosing SSc. Capillaroscopy, however, usually requires special equipment and may be time consuming. Dermatoscope has been presented as a new diagnostic tool for quick and efficient examination of nailfold capillaries for circumstances when standard microscope equipment is not available. To assess the practical utility of dermatoscope for assessment of capillary morphology in patients with SSc, 83 Japanese patients with SSc (68 women, 15 men) and 68 healthy controls were examined in the study. Twenty-one patients (16 women, 5 men) had diffuse cutaneous SSc and 62 (52 women, 10 men) had limited cutaneous SSc. Enlarged capillaries and hemorrhages were evaluated in all 10 fingers with either naked eyes or DermLite(®) DL100 dermatoscope. Enlarged capillaries and hemorrhages were significantly more frequently detected with dermatoscope than without it. These findings were observed most frequently in the fourth finger. The presence of two or more enlarged capillaries in one or more fingers showed 83.1% sensitivity and 100% specificity for SSc. Among patients with SSc with anti-topoisomerase I antibody, the disease duration correlated negatively with the dermatoscopic number of enlarged capillaries and hemorrhages. Dermatoscope allows the easy and rapid identification of capillary nailfold morphological changes in SSc and should be routinely used for diagnosing SSc.
authors.affiliation: Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Muroi
authors.forename: Toshihide
authors.initials: T
authors.lastname: Hara
authors.forename: Koichi
authors.initials: K
authors.lastname: Yanaba
authors.forename: Fumihide
authors.initials: F
authors.lastname: Ogawa
authors.forename: Ayumi
authors.initials: A
authors.lastname: Yoshizaki
authors.forename: Motoi
authors.initials: M
authors.lastname: Takenaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shimizu
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000906:Antibodies / Q000097:blood / Q000276:immunology; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology; D002196:Capillaries / Q000276:immunology / Q000503:physiopathology*; D004264:DNA Topoisomerases, Type I / Q000276:immunology; D046169:Dermoscopy / Q000295:instrumentation*; D005260:Female; D005385:Fingers / Q000098:blood supply; D006470:Hemorrhage / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D008297:Male; D009262:Nails / Q000098:blood supply* / Q000276:immunology; D012595:Scleroderma, Systemic / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D012680:Sensitivity and Specificity
chemical_list: D000906:Antibodies; D000974:Antibodies, Antinuclear; D004264:DNA Topoisomerases, Type I; C528909:TOP1 protein, human