Nailfold capillaroscopy : a comprehensive review on common findings and clinical usefulness in non-rheumatic disease

Abstract

Nailfold video-capillaroscopy (NVC) is a useful diagnostic tool, used to early detect abnormalities in micro-circulation, providing a qualitative description of microvascular anomalies in Raynaud's phenomenon. NVC role in the diagnosis of Systemic Sclerosis is well known. In other rheumatic conditions such as connective tissue diseases, vasculitis, and arthritis, the NVC anomalies are often included in a scleroderma like pattern. The use of NVC in non-rheumatic diseases (NRD), with remarkable microvascular damage, as diabetes, is not standardized yet, although several research studies are carrying on. The aim of this article is to provide a resume of published results in order to lay the groundwork for the employment of NVC both in the diagnosis and follow up of microvascular complication in NRD. Furthermore, we mention NVC findings in pathologies without well recognize microvascular damages in their pathogenesis : micro-vessels abnormalities may suggest a different point of view.

Patients with Systemic Sclerosis with and without Overlap Syndrome Show Similar Microvascular Abnormalities

“…Future multicenter studies are required with a standardized methodology and patient selection to clarify the importance of our current findings. A limitation of our study is that we included patients with hypertension and diabetes, and these particular comorbidities might have an impact on our capillaroscopy findings [53,54]. Another weakness of our study is that the disease activity and treatment were not evaluated in different CTDs.…”

Automated capillary flow segmentation and mapping for nailfold video capillaroscopy

“…Additional work is required to determine the chronological changes in these parameters in normal aging. With a pattern recognition method, discrimination between normal and abnormal states, such as diabetes mellitus, hypertension, pulmonary disease, hematological diseases, peripheral arterial occlusive, and connective tissue diseases, 9,35 may be possible. For this purpose, reactive hyperemia tests, in addition to resting state measurements, will improve precision in diagnosing capillary functions 32 …”

Nail Folds Capillaries Abnormalities Associated With Type 2 Diabetes Mellitus Progression and Correlation With Diabetic Retinopathy

“… 13 , 14 Examining 5 or 4 fingers in the hand means that 10 or 8 fingers were examined, and 4 shots were taken for each finger to evaluate the capillaries. 2 , 15 The updated Maricq criteria were used to assess capillary distribution, density, and morphology in the nail fold capillary system. 16 Abnormal capillaroscopic outcomes were identified as tortuosity, neoangiogenesis, microhemorrhage, extravasation, avascular areas, bizarre capillary, ectatic capillaries or megacapillary.…”

“…It was designated as a “standard investigation” in rheumatologic management due to its high sensitivity and specificity, lack of invasiveness, ease of procedure, and rapid execution time at a cheap cost. 1 - 4 …”

“…It was designated as a "standard investigation" in rheumatologic management due to its high sensitivity and specificity, lack of invasiveness, ease of procedure, and rapid execution time at a cheap cost. [1][2][3][4] The nailfold capillaroscopy (NVC) consists of a digital video camera and an optical microscope that are both connected to a computer that calibrates the data and records capillary measurements 5 . It provides information on morphological and hemodynamic factors such as extension predictive value, gravity, and illness prognosis, among others.…”