Deterioration of cutaneous microcirculatory status of Kawasaki disease

Abstract

Kawasaki disease (KD) is associated with generalized vasculitis with a predilection for coronary artery leading to ectasia and aneurysm in some cases. The aim of this study was to noninvasively assess the cutaneous microcirculation and correlate it with the coronary artery diameter in these patients. Laser Doppler flowmetry and dynamic capillaroscopy were performed at the nailbeds to assess total cutaneous blood flow and microcirculation in children with KD, both in the afebrile phase (after the resolution of fever) and convalescent phases, in comparison to controls. The 100 subjects analyzed in this study included 64 patients with KD (33 in afebrile phase and 31 in convalescent phase) and 36 normal controls. In KD, the capillary morphology was abnormal when compared to controls, with a larger diameter of the arterial and venous limbs, a higher intercapillary distance and a decrease in the loop numbers. Significantly decreased capillary blood cell velocity was noted in afebrile phase but not in convalescent phase. In the afebrile phase, a decreased capillary blood cell velocity significantly correlated with an increased coronary artery diameter. In conclusion, KD patients, both in the afebrile and convalescent phases, exhibited morphologic alterations in the microcirculation when compared to the controls. The results indicate the potential role of dynamic capillaroscopy for the noninvasive survey of microcirculation abnormalities in patients with KD.

Nailfold Capillaroscopy in Pediatrics

“…Coronary arteries are involved in the majority of cases, and aneurysms are the major manifestation of the disease. A study of 64 children with Kawasaki disease reported capillary morphologic abnormalities both in the afebrile and convalescent phases of disease, including an increased diameter of the arterial and venous limbs, a higher intercapillary distance, and a decrease in the loop numbers ().…”

Fundamental supply of skin blood flow in the Chinese Han population: Measurements by a full‐field laser perfusion imager

“…Skin covers the body and is known as the largest organ in the human and the most important role is its barrier functions. 13,14 Previously study had approved microcirculation of skin is related to systemic disease, such as systemic sclerosis, 15 Kawasaki disease, 16 polycystic ovary syndrome, 17 burn scar, Bell's palsy, and acute radio dermatitis. [18][19][20] Our study confirmed that blood flow in different cutaneous regions varied.…”

The Impact of Nailfold Capillaroscopy in the Approach of Microcirculation

“…Only one study about Kawasaki disease and NFC was found and it involved 64 pediatric patients [44]. Microcirculation abnormalities found included reduced density, dilation of arterial and venous limb diameters, higher intercapillary distance, and abnormal loops.…”