Nailfold Videocapillaroscopy Alterations in Dermatomyositis and Systemic Sclerosis: Toward Identification of a Specific Pattern

Manfredi, Andreina; Sebastiani, Marco; Campomori, Federica; Pipitone, Nicolò; Giuggioli, Dilia; Colaci, Michele; Praino, Emanuela; Ferri, Clodoveo

doi:10.3899/jrheum.160122

Cited by 26 publications

(19 citation statements)

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“…Moreover, we observed differences between SSc pattern and DM pattern (observed in patients with DM). In DM, giant and ramified capillaries were seen at disease onset, while in patients with longer disease duration, DM pattern regressed and only brushing capillaries were observed 23 . At present, we cannot establish whether patients with AS are characterized by true SSc-specific patterns 24 or DM pattern 23 or by a specific AS pattern.…”

Section: Discussionmentioning

confidence: 97%

“…In DM, giant and ramified capillaries were seen at disease onset, while in patients with longer disease duration, DM pattern regressed and only brushing capillaries were observed 23 . At present, we cannot establish whether patients with AS are characterized by true SSc-specific patterns 24 or DM pattern 23 or by a specific AS pattern. For this reason, comparison studies of AS with SSc and DM are required to address this question, and the term SSc-like pattern appears to be more proper.…”

Section: Discussionmentioning

confidence: 97%

“…Because some NVC features are occasionally observed in only 1 or a few fingers without clinical significance, to better evaluate the severity of these capillaroscopic alterations, we also evaluated the percentages of images per patient with microhemorrhages, ramified capillaries, giant capillaries, and avascular areas. Moreover, an SSc pattern, defined as an alteration of the nailfold microvascular network characterized by enlarged and giant loops, microhemorrhages, capillary loss, ramified capillaries, and architectural disorganization 20,21,22,23,24 , was recorded as being present or absent. In the absence of validated criteria and of comparison studies, we choose to use the term "SSc-like" in the presence of an NVC pattern similar to the SSc pattern.…”

Section: Methodsmentioning

confidence: 99%

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Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

et al. 2018

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Objective.To describe nailfold videocapillaroscopy (NVC) features of patients with antisynthetase syndrome (AS) and to investigate possible correlations with clinical and serological features of the disease.Methods.We retrospectively analyzed NVC images of 190 patients with AS [females/males 3.63, mean age 49.7 ± 12.8 yrs, median disease duration 53.7 mos (interquartile range 82), 133 anti-Jo1 and 57 non–anti-Jo1-positive patients]. For each patient, we examined number of capillaries, giant capillaries, microhemorrhages, avascular areas, ramified capillaries, and the presence of systemic sclerosis (SSc)-like pattern. Finally, we correlated NVC features with clinical and serological findings of patients with AS. Concomitantly, a historical cohort of 75 patients with antinuclear antibody–negative primary Raynaud phenomenon (RP) and longterm followup was used as a control group (female/male ratio 4.13/1, mean age 53.9 ± 17.6 yrs) for NVC measures.Results.NVC abnormalities were observed in 62.1% of AS patients compared with 29.3% of primary RP group (p < 0.001). An SSc-like pattern was detected in 67 patients (35.3%) and it was associated with anti-Jo1 antibodies (p = 0.002) and also with a longer disease duration (p = 0.004). Interestingly, there was no significant correlation between the presence of SSc-like pattern and RP, and only 47% of patients with SSc-like pattern had RP.Conclusion.NVC abnormalities are commonly observed in AS, independently from the occurrence of RP. The presence of an SSc-like pattern could allow identification of a more defined AS subtype, and prospective studies could confirm the association with clinical and serological features of AS.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

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Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

et al. 2018

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“…The recent introduction of low-cost IR cameras can increase the availability of IRT, which has so far been restricted to specialist tertiary care units. Such devices have a thermal resolution of 0.1°C, which is acceptable for medical usage, and, in spite of certain limitations [22], can find a place in everyday clinical practice [23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Raynaud's phenomenon secondary to dermatomyositis at baseline (A), with only partial rewarming after heat challenge (B). Giant-ramified capillaries are suggestive of dermatomyositis-pattern (C)[24].…”

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confidence: 99%

Infrared thermal imaging in connective tissue diseases

Chojnowski¹

2017

Reumatologia

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Infrared thermal imaging (IRT) is a non-invasive, non-contact technique which allows one to measure and visualize infrared radiation. In medicine, thermal imaging has been used for more than 50 years in various clinical settings, including Raynaud’s phenomenon and systemic sclerosis. Imaging and quantification of surface body temperature provides an indirect measure of the microcirculation’s overall performance. As such, IRT is capable of confirming the diagnosis of Raynaud’s phenomenon, and, with additional cold or heat challenge, of differentiating between the primary and secondary condition. In systemic sclerosis IRT has a potential role in assessing disease activity and monitoring treatment response. Despite certain limitations, thermal imaging can find a place in clinical practice, and with the introduction of small, low-cost infrared cameras, possibly become a part of routine rheumatological evaluation.

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Early improvement of nailfold videocapillaroscopy abnormalities in dermatomyositis patients with anti‐NXP‐2 antibody

Mugii,

Hamaguchi,

Fushida

et al. 2023

J Cutaneous Imm & Allergy

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This study aimed to evaluate long‐term changes in nailfold videocapillaroscopy (NVC) findings in dermatomyositis patients with antinuclear matrix protein 2 (NXP‐2) antibody (Ab). All four patients with anti‐NXP‐2 Ab presented irregularly enlarged and reduced capillaries and hemorrhages at the initial assessment. After disease stabilization, irregularly enlarged capillaries and hemorrhages disappeared within the mean observation period of 6 months. These early improvements were not observed in patients with anti‐TIF1 Ab. The results of this study show that long‐term changes in NVC findings should be assessed using myositis‐specific Ab information.

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Nailfold Videocapillaroscopy Alterations in Dermatomyositis and Systemic Sclerosis: Toward Identification of a Specific Pattern

Abstract: Our study strengthens the specificity of DM and SSc microangiopathy and points out the need for large prospective studies to confirm our results and possibly to revise current terminology by distinguishing between "scleroderma" and "dermatomyositis" patterns.

Cited by 26 publications

References 29 publications

Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study

Infrared thermal imaging in connective tissue diseases

Early improvement of nailfold videocapillaroscopy abnormalities in dermatomyositis patients with anti‐NXP‐2 antibody

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