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Nailfold capillaroscopy

Carina Mihai, Vanessa Smith, Rucsandra Dobrota, Ana Maria Gheorghiu, Maurizio Cutolo, Oliver Distler
Systemic sclerosis (SSc) is a connective tissue disease with high morbidity and mortality, characterized by autoimmunity, obliterative vasculopathy involving mainly the microvasculature, and fibrosis. SSc-specific nailfold capillaroscopic changes have been defined, and nailfold capillaroscopy (NFC) is now unequivocally accepted to be a cornerstone for the early diagnosis of SSc. However, the use of NFC in patients already diagnosed with SSc is still not standardized. Several studies have shown that NFC abnormalities correlate with disease activity and severity and are predictive for disease worsening, such as occurrence of new digital ulcers...
March 12, 2018: Microvascular Research
Ariane L Herrick, Andrea Murray
Most patients with Raynaud's phenomenon (RP) have "benign" primary RP (PRP), but a minority have an underlying cause, for example a connective tissue disease such as systemic sclerosis (SSc). Secondary RP can be associated with structural as well as functional digital vascular changes and can be very severe, potentially progressing to digital ulceration or gangrene. The first step in management is to establish why the patient has RP. This short review discusses the role of nailfold capillaroscopy and thermography in the assessment of RP...
March 8, 2018: Autoimmunity Reviews
Caterina Matucci-Cerinic, Vivek Nagaraja, Francesca Prignano, Bashar Kahaleh, Silvia Bellando-Randone
Raynaud's phenomenon (RP) is a functional vascular disorder involving extremities. In his practice, the dermatologist may frequently encounter RP which affects mainly women and is categorized into a primary benign form and a secondary form associated with different diseases (infections, drugs, autoimmune and vascular conditions, hematologic, rheumatologic and endocrinologic disorders). Still today, the differential diagnosis is a clinical challenge. Therefore, a careful history and a physical examination, together with laboratory tests and nailfold capillaroscopy are mandatory...
March 6, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Graham Dinsdale, Anniek M van Roon, Andrea Murray, Christopher Taylor, Ariane L Herrick
No abstract text is available yet for this article.
February 28, 2018: Rheumatology
Tatiana Sofía Rodriguez-Reyna, Chiara Bertolazzi, Angélica Vargas-Guerrero, Marwin Gutiérrez, Gabriela Hernández-Molina, Marcelo Audisio, Susana Roverano, Margarita González de Urizar, José Francisco Díaz Coto, Blanca Elizabeth Herrera Velasco, Mijahil Pavel Cornejo Ortega, Ana María Sapag Durán, Janeth Edelina Villegas Guzmán, Luís Fernando Medina Quintero, Mirtha Sabelli, Sandy Sapag Durán, Maurizio Cutolo
Nailfold videocapillaroscopy (VCP) allows non-invasive assessment of the microcirculation. Adequate training in this field is relevant for rheumatologists. There is increasing evidence of the reliability of VCP findings among different readers. OBJECTIVE: To evaluate inter- and intra-reader agreement of rheumatologists to identify normal images and systemic sclerosis (SSc) patterns on VCP ("early," "active," and "late" proposed by Cutolo et al.). Thirteen rheumatologists with different experience in nailfold VCP received training to standardize reading criteria...
February 23, 2018: Clinical Rheumatology
Ewa Kosior-Jarecka, Joanna Bartosińska, Urszula Łukasik, Dominika Wróbel-Dudzińska, Dorota Krasowska, Grażyna Chodorowska, Tomasz Żarnowski
The aim of the study was to evaluate the results of nailfold videocapillaroscopic examination in patients with normal-tension glaucoma (NTG) in comparison to age-matched individuals without glaucoma and young healthy volunteers and to assess the relation between the results of this examination with clinical status in NTG group. MATERIAL AND METHODS: The studied group consisted of 188 patients: 80 patients with NTG and 2 control groups (58 young healthy and 50 age-matched volunteers). The nailfold videocapillaroscopy (NVC) was performed in all participants...
February 16, 2018: Current Eye Research
Sevdalina Nikolova Lambova, Ulf Muller-Ladner
No abstract text is available yet for this article.
February 14, 2018: Current Rheumatology Reviews
Maurizio Cutolo, Karin Melsens, Sara Wijnant, Francesca Ingegnoli, Kristof Thevissen, Filip De Keyser, Saskia Decuman, Ulf Müller-Ladner, Yves Piette, Valeria Riccieri, Nicola Ughi, Els Vandecasteele, Amber Vanhaecke, Vanessa Smith
Nailfold capillaroscopy is an easy, non-invasive technique to assess microvascular involvement in rheumatic diseases. Multiple studies describe capillaroscopic changes in systemic lupus erythematosus (SLE), including a wide range of non-specific findings. On behalf of the European League Against Rheumatism (EULAR) study group on microcirculation in rheumatic diseases, a systematic review was done to obtain all original research studies (in English) in which SLE patients had capillaroscopy. Forty such studies are identified...
February 7, 2018: Autoimmunity Reviews
Sevdalina Nikolova Lambova, Ulf Müller-Ladner
A 67-year-old woman with triphasic Raynaud's phenomenon since 2 years was diagnosed as having limited cutaneous systemic sclerosis (SSc) 1 year ago based on puffy fingers, positive antinuclear and anti-Scl-70 autoantibodies, and initial pulmonary fibrosis. Capillaroscopic examination revealed "mosaic" capillaroscopic findings that included normal pattern; "scleroderma"-type capillaroscopic pattern "early" phase, with single giant capillaries and haemorrhages, preserved capillary distribution; and "scleroderma"-type capillaroscopic pattern "active" phase, with high number of giant capillary loops and haemorrhages, moderately disturbed distribution...
February 1, 2018: Wiener Medizinische Wochenschrift
Joanna Tieu, Paul Hakendorf, Richard J Woodman, Karen Patterson, Jenny Walker, Peter Roberts-Thomson
AIM: Semi-quantitative wide-field nailfold capillaroscopy (NFC) is a simple technique with proven utility in the early diagnosis of systemic sclerosis (SSc). Its role in prognosis, however, remains uncertain. This studyseeks to investigate the possible utility of NFC in predicting survival. METHODS: Patients with SSc listed on the South Australian Scleroderma Register (SASR) with prior NFC performed at Flinders Medical Centre from 1991 to 2015 were included in this study...
January 24, 2018: Internal Medicine Journal
Yuki Ichimura, Yasushi Kawaguchi, Kae Takagi, Akiko Tochimoto, Tomoaki Higuchi, Sayuri Kataoka, Yasuhiro Katsumata, Hisashi Yamanaka
No abstract text is available yet for this article.
January 22, 2018: Modern Rheumatology
D Sánchez-Cano, N Ortego-Centeno, J L Callejas, V Fonollosa Plá, R Ríos-Fernández, C Tolosa-Vilella, G Espinosa-Garriga, D Colunga-Argüelles, M V Egurbide-Arberas, M Rubio-Rivas, M Freire, J J Ríos-Blanco, L Trapiella-Martínez, M Rodríguez-Carballeira, A Marín-Ballvé, X Pla-Salas, C P Simeón-Aznar
OBJECTIVES: To evaluate the clinical characteristics of patients with interstitial lung disease (ILD) in the setting of a large cohort of systemic sclerosis (SSc) patients, and to analyse the differences according to the SSc subtype (following the modification of classification criteria of the American College of Rheumatology for SSc proposed by LeRoy and Medsger), factors are associated with moderate-to-severe impairment of lung function, as well as mortality and causes of death. METHODS: A descriptive study was performed, using the available data from the Spanish Scleroderma Study Group...
March 2018: Rheumatology International
R Talotta, S Bongiovanni, T Letizia, F Rigamonti, F Atzeni, M Benucci, T Vago, P Sarzi-Puttini
The aim was to evaluate the role of klotho in the pathogenesis of systemic sclerosis (SSc), through the measurement of its serum concentration in SSc patients compared to healthy controls, and to assess the association with cutaneous and visceral involvement. Blood samples obtained from both SSc patients and healthy controls were analysed by an ELISA assay for the detection of human klotho. SSc patients were globally evaluated for disease activity and assessed through the modified Rodnan's Skin Score, Medsger's scale, pulmonary function tests, 2D-echocardiography, nailfold capillaroscopy and laboratory tests...
December 21, 2017: Reumatismo
Matthew J S Parker, Michael T Oliffe, Neil W McGill
OBJECTIVES: The primary aim was to evaluate the diagnostic performance of digital photographs taken with a smartphone camera using both a lens attachment and, separately, a dermatoscope. The secondary aims were to assess the influence of prior capillaroscopy experience and familiarity with the novel techniques on diagnostic accuracy. METHODS: All patients referred for capillaroscopy between May 2016 and January 2017 were eligible for inclusion. Nailfolds were classified by widefield microscopy before proceeding double-blinded to nailfold photography using both novel techniques...
December 20, 2017: Modern Rheumatology
Alireza Rajaei, Pooneh Dehghan, Ali Amiri
Background: Microvascular changes are one of the first obvious steps in numerous inflammatory diseases such as rheumatoid arthritis (RA). Nailfold video capillaroscopy (NFC) is an easy, reliable and safe method for evaluating peripheral microangiopathy. The objective of this study was to examine nailfold microcirculation in RA patients, assess morphological and structural changes quantitatively and qualitatively, and recognize useful changes. Methods: A total of 430 patients diagnosed with RA were examined in a period of 4 years...
2017: Caspian Journal of Internal Medicine
Ariane L Herrick
Raynaud's phenomenon (RP) is relevant to the rheumatologist because it may signify an underlying connective tissue disease and also because it can be very challenging to treat, especially when it has progressed to digital ulceration or critical ischaemia. This review article discusses diagnosis (does this patient have an underlying connective tissue disease?), including the role for nailfold capillaroscopy, and treatment. Management of 'uncomplicated' RP is first described and then treatment of RP complicated by progression to digital ulceration or critical ischaemia, highlighting recent advances (including phosphodiesterase type 5 inhibition, and endothelin 1 receptor antagonism) and the evidence base underpinning these...
December 2017: Therapeutic Advances in Musculoskeletal Disease
Thais Rohde Pavan, Markus Bredemeier, Vanessa Hax, Karina Gatz Capobianco, Rafael da Silva Mendonça Chakr, Ricardo Machado Xavier
The objective of this study is to test the association of the severity of nailfold capillaroscopy (NFC) abnormalities with mortality in systemic sclerosis (SSc). One hundred and seventy SSc patients underwent an extensive evaluation (including high-resolution computed tomography, pulmonary function tests, and Doppler echocardiography) at baseline following a standard protocol. Capillary loss on NFC was evaluated using the avascular score (AS, ranging from 0 to 3), and the mean number of ectasias, megacapillaries, and hemorrhages per finger was also recorded...
October 10, 2017: Clinical Rheumatology
Carine Boulon, Sophie Blaise, Isabelle Lazareth, Claire Le Hello, Marc-Antoine Pistorius, Bernard Imbert, Marion Mangin, Pierre Sintes, Patricia Senet, Joëlle Decamps-Le Chevoir, Laurent Tribout, Patrick Carpentier, Joël Constans
Objectives: The aim of this work was to study inter- and intra-observer agreement for the diagnosis of scleroderma pattern by wide-field capillaroscopy. Methods: Images were taken from 50 patients known to have SSc and 50 controls consulting for RP who did not have SSc. These images were rated simultaneously by 11 experienced vascular medicine physicians as scleroderma pattern or not. Two weeks later, 7 of the 11 observers again rated the same images. Results: Inter-observer agreement was almost perfect between the 11 observers (κ 0...
October 1, 2017: Rheumatology
Serdar Can Güven, Özkan Varan, Hamit Küçük
No abstract text is available yet for this article.
October 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Alain Lescoat, Guillaume Coiffier, Marine de Carlan, Catherine Droitcourt, Alice Ballerie, Cazalets Claire, Aleth Perdriger, Jégo Patrick
OBJECTIVES: To compare microvascular damages on nailfold capillaroscopy (NC) with macrovascular manifestations evaluated by hand power doppler ultrasonography (PDUS) in Systemic Sclerosis (SSc) patients, and to assess the associations of these damages with the main digital manifestations of the disease: digital ulcers (DU), acro-osteolysis and Calcinosis. METHODS: NC, hand X-Rays and PDUS were systematically performed in 64 unselected SSc patients. PDUS evaluation with assessment of ulnar artery occlusion (UAO) and finger pulp blood flow (FPBF) was performed blinded for the results of X-Rays and NC...
September 12, 2017: Arthritis Care & Research
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