Nailfold capillaroscopy for day-to-day clinical use: construction of a simple scoring modality as a clinical prognostic index for digital trophic lesions.
OBJECTIVE
Construction of a simple nailfold videocapillaroscopic (NVC) scoring modality as a prognostic index for digital trophic lesions for day-to-day clinical use.


METHODS
An association with a single simple (semi)-quantitatively scored NVC parameter, mean score of capillary loss, was explored in 71 consecutive patients with systemic sclerosis (SSc), and reliable reduction in the number of investigated fields (F32-F16-F8-F4). The cut-off value of the prognostic index (mean score of capillary loss calculated over a reduced number of fields) for present/future digital trophic lesions was selected by receiver operating curve (ROC) analysis.


RESULTS
Reduction in the number of fields for mean score of capillary loss was reliable from F32 to F8 (intraclass correlation coefficient of F16/F32: 0.97; F8/F32: 0.90). Based on ROC analysis, a prognostic index (mean score of capillary loss as calculated over F8) with a cut-off value of 1.67 is proposed. This value has a sensitivity of 72.22/70.00, specificity of 70.59/69.77, positive likelihood ratio of 2.46/2.32 and a negative likelihood ratio of 0.39/0.43 for present/future digital trophic lesions.


CONCLUSIONS
A simple prognostic index for digital trophic lesions for daily use in SSc clinics is proposed, limited to the mean score of capillary loss as calculated over eight fields (8 fingers, 1 field per finger).
Department of Rheumatology, Ghent University Hospital, Belgium. vanessa.smith@ugent.be
Vanessa
V
Smith
Filip
F
De Keyser
Carmen
C
Pizzorni
Jens T
JT
Van Praet
Saskia
S
Decuman
Alberto
A
Sulli
Ellen
E
Deschepper
Maurizio
M
Cutolo
D000328:Adult; D000368:Aged; D002196:Capillaries / Q000473:pathology; D005260:Female; D005385:Fingers / Q000098:blood supply; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods; D008875:Middle Aged; D009262:Nails / Q000098:blood supply*; D011379:Prognosis; D012595:Scleroderma, Systemic / Q000175:diagnosis*; D012720:Severity of Illness Index; D014741:Video Recording