title: Assessment of nailfold capillaries with a handheld dermatoscope may discriminate the extent of organ involvement in patients with systemic sclerosis.
abstract: To investigate whether nailfold capillaroscopy (NFC) patterns assessed through an in-office handheld dermatoscope may reflect the extent of disease severity in systemic sclerosis (SSc). NFC patterns were evaluated with a non-contact, polarized light dermatoscope in 40 consecutive patients with SSc and graded in sequence as 0 = normal, 1 = early, 2 = active, or 3 = late patterns. Disease severity was measured according to a modified Medsger severity scale (MSS). For comparisons, patients were grouped in tertiles according to disease severity, and a numerical correlation between the NFC patterns and the composite MSS score was assessed. Twenty patients had normal or early NFC patterns, most of them (17 individuals, 85 %) having low to moderate disease severity. In contrast, 18 out of 20 (90 %) patients with active or late NFC patterns had moderate to high disease severity. Accordingly, patients with normal/early NFC patterns had a median MSS score of 4 (interquartile range (IQR), 3-5) as compared with 7 (4-8; P = 0.02) in those with active/late patterns. A Spearman's rho coefficient of 0.45 (95 % CI, 0.15-0.67; P = 0.003) was found between the graded scale of NFC patterns and the composite MSS score. A handheld dermatoscope is useful to visualize the NFC patterns in SSc patients, and it is efficient enough to reflect the extent of disease severity.
authors.affiliation: Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Arana-Ruiz
authors.affiliation: Department of Rheumatology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Luis H
authors.initials: LH
authors.lastname: Silveira
authors.affiliation: Department of Dermatology, Hospital General de Zona 32 Villa Coapa, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
authors.forename: Diana
authors.initials: D
authors.lastname: Castillo-Martínez
authors.affiliation: Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, 14080 Tlalpan, Mexico City, Mexico. lmamezcuag@gmail.com.|Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico. lmamezcuag@gmail.com.|School of Medicine, La Salle University, Mexico City, Mexico. lmamezcuag@gmail.com.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Amezcua-Guerra
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D046169:Dermoscopy; D005260:Female; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D009262:Nails / Q000098:blood supply / Q000473:pathology*; D012595:Scleroderma, Systemic / Q000473:pathology*
keywords: Dermatoscope; Nailfold capillaries; Systemic sclerosis; Videocapillaroscopy