title: Capillaroscopic Skin Ulcers Risk Index (CSURI) calculated with different videocapillaroscopy devices: how its predictive values change.
abstract: BACKGROUND
  Digital ulcers (DU) occur in about 50% of systemic sclerosis (SSc) patients. Scleroderma DU are responsible for chronic pain and disability with the need of systemic and local treatments. Recently, capillaroscopic skin ulcer risk index (CSURI) has been validated as useful tool in predicting the appearance of new scleroderma ulcers and/or persistence of non-healing lesions, within 3 months from capillaroscopy evaluation.
  
  
  OBJECTIVE
  Since the image length of 1.57 mm might represent a critical factor for CSURI calculation, the present study aimed to evaluate the reliability of CSURI using three different videocapillaroscopy devices with distinct image widths.
  
  
  METHODS
  One hundred and seventy-six unselected SSc patients were consecutively enrolled for the study during a six-month period, using three different capillaroscopy devices (image widths of 1.33, 1.57, and 1.70 mm).
  
  
  RESULTS
  After a three month-follow-up new DU or persisting non-healing ulcers were observed in 46/176 patients (26.1%). The receiver operating characteristic curve analysis for CSURI showed an area under curve respectively of 0.705 for the image width of 1.33 mm, 0.786 for the image of 1.70 mm, and 0.888 for the image width of 1.57 mm.
  
  
  CONCLUSIONS
  The good sensitivity, specificity and positive predictive value of CSURI was confirmed in the whole patients' series, as well as in the three subgroups on different image widths obtained with various available devices. In addition, the negative predictive value of the capillaroscopic index remained very high regardless of the picture length adopted.
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy. marco.sebastiani@unnimore.it
authors.forename: Marco
authors.initials: M
authors.lastname: Sebastiani
authors.forename: Andreina
authors.initials: A
authors.lastname: Manfredi
authors.forename: Andrea
authors.initials: A
authors.lastname: Lo Monaco
authors.forename: Emanuela
authors.initials: E
authors.lastname: Praino
authors.forename: Valeria
authors.initials: V
authors.lastname: Riccieri
authors.forename: Vito
authors.initials: V
authors.lastname: Grattagliano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bortoluzzi
authors.forename: Katia
authors.initials: K
authors.lastname: Stefanantoni
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Amico
authors.forename: Dilia
authors.initials: D
authors.lastname: Giuggioli
authors.forename: Clodoveo
authors.initials: C
authors.lastname: Ferri
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005385:Fingers; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy / Q000295:instrumentation* / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply; D012883:Skin Ulcer / Q000175:diagnosis* / Q000453:epidemiology*