title: The relationship between nailfold capillaroscopic assessment and telangiectasia score with severity of peripheral vascular involvement in systemic sclerosis.
abstract: OBJECTIVE
  To determine the association of nailfold video-capillaroscopy (NVC) findings and telangiectasia score with digital ulcer (DU) history and severity of peripheral vascular involvement (PVI) in systemic sclerosis (SSc).
  
  
  METHODS
  Fifty-nine SSc patients fulfilling Leroy & Medsger criteria were evaluated including telangiectasia score, disease activity and severity scores. NVC was performed according to qualitative (early, active and late patterns) and semi-quantitative assessments.
  
  
  RESULTS
  When DU+ and DU- groups were compared; the mean score of capillary number (CN) was 2.0±0.5 vs. 1.4±0.7 (p<0.001), irregularly enlarged capillaries (IEC) was 1.8±0.6 vs. 1.4±0.7 (p<0.05), microangiopathy evolution score (MES) was 2.5±1.5 vs. 1.8±1.0 (p<0.05) and 'early' pattern was significantly less frequent in DU+ patients (1 vs. 9, p=0.016). The frequency of severe-PVI (Medsger severity score of 2-4) was 22% in females (12/54) and 80% in males (4/5). When severe and non-severe groups were compared; the mean score of CN was 2.1±0.4 vs. 1.5±0.7 (p<0.001), MES was 2.8±1.6 vs. 1.8±1.1 (p<0.05) and 'early' pattern was significantly less frequent in patients with severe PVI (0 vs. 9, p=0.049). The mean values of telangiectasia score were similar between groups.
  
  
  CONCLUSIONS
  DU history and severe PVI in SSc were associated with capillary loss and microangiopathy. 'Early' NVC pattern was very rare in patients with DU history and was not found in severe PVI. Severe PVI in males was more frequent than females. Telangiectasia scores were not found to be related to PVI. NVC may be a helpful method in the assessment of SSc patients for PVI prognosis, warranting prospective studies.
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey. yasemin_sahinkaya@hotmail.com.
authors: Yasemin
authors: Y
authors: Yalcinkaya
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Ozlem
authors: O
authors: Pehlivan
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Ahmet
authors: A
authors: Omma
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Nilufer
authors: N
authors: Alpay
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Burak
authors: B
authors: Erer
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Sevil
authors: S
authors: Kamali
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Lale
authors: L
authors: Ocal
authors: Division of Rheumatology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors: Murat
authors: M
authors: Inanc
mesh_terms: D000328:Adult; D002196:Capillaries / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods; D008875:Middle Aged; D009262:Nails / Q000098:blood supply*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D012737:Sex Factors; D012883:Skin Ulcer / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D013684:Telangiectasis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D014741:Video Recording