Abstract
Capillaroscopy is an essential imaging technique used in the study of microcirculation and one of the best diagnostic tools for the early detection of systemic sclerosis and related conditions. However, despite the increasing interest in capillary microscopy, there is still a surprising discrepancy between its potential application and its still limited use in rheumatological practice. This contrast is really surprising because few diagnostic techniques can combine all the positive features typical of capillaroscopy (low cost, uninvasiveness, repeatability, high sensitivity, good specificity, easy interpretation of results). The lack of guidelines and recommendations concerning the right way to carry out a correct capillaroscopic examination and the interpretation of the most relevant capillaroscopic abnormalities may represent one of the major drawbacks for its widespread use. Discussion about controversies on this topic should be encouraged, leading to a progressive development of capillaroscopy as a routine investigation in rheumatology.
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References
Maricq HR (1981) Wide-field capillary microscopy. Arthritis Rheum 24:1159–1165
Houtman PM, Kallenberg CGM, Fidler V et al (1986) Diagnostic significance of nailfold capillary patterns in patients with Raynaud’s phenomenon. J Rheumatol 13:556–563
Statham BN, Rowell NR (1986) Quantification of the nailfold capillary abnormalities in systemic sclerosis and Raynaud’s phenomenon. Acta Derm Venereol 66:139–143
Carpentier PH, Maricq HR (1990) Microvasculature in systemic sclerosis. Rheum Dis Clin North Am 16:75–91
Wong ML, Highton J, Palmer DG (1988) Sequential nailfold capillary microscopy in scleroderma and related disorders. Ann Rheum Dis 47:53–61
Lefford F, Edwards JCW (1986) Nailfold capillary microscopy in connective tissue disease: a quantitative morphological analysis. Ann Rheum Dis 45:741–749
Scheja A, Akesson A, Niewierowicz I et al (1996) Computer based quantitative analysis of capillary abnormalities in systemic sclerosis and its relation to plasma concentration of von Willebrand factor. Ann Rheum Dis 55:52–56
Chen ZY, Silver RM, Ainsworth SK et al (1984) Association between fluorescent antinuclear antibodies, capillary patterns, and clinical features in scleroderma spectrum disorders. Am J Med 77:812–822
Lovy M, MacCarter D, Steigerwald JC (1985) Relationship between nailfold capillary abnormalities and organ involvement in systemic sclerosis. Arthritis Rheum 28:496–501
Schmidt KU, Mensing H (1988) Are nailfold capillary changes indicators of organ involvement in progressive systemic sclerosis? Dermatologica 176:18–21
Cutolo M, Sulli A, Pizzorni C et al (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160
Grassi W, Core P, Cervini C (1996) Increased capillary permeability in systemic sclerosis: help or hindrance? Ann Rheum Dis 55:603–606
LeRoy EC, Medsger TA Jr (1992) Raynaud’s phenomenon: a proposal for classification. Clin Exp Rheumatol 10:485–488
Cutolo M, Grassi W, Matucci Cerinic M (2003) Raynaud’s phenomenon and the role of capillaroscopy. Arthritis Rheum 48:3023–3030
Grassi W, Del Medico P, Izzo F et al (2001) Microvascular involvement in systemic sclerosis: capillaroscopic findings. Semin Arthritis Rheum 30:397–402
Anders HJ, Sigl T, Schattenkirchner N (2001) Differentiation between primary and secondary Raynaud’s phenomenon: a prospective study comparing nailfold capillaroscopy using an ophtalmoscope or stereomicroscope. Ann Rheum Dis 60:407–409
Bergman R, Sharony L, Schapira D et al (2003) The handheld dermatoscope as a nailfold capillaroscopic instrument. Arch Dermatol 139:1027–1030
Tektonidou M, Kaskani E, Skopouli FN et al (1999) Microvascular abnormalities in Sjögren’s syndrome: nailfold capillaroscopy. Rheumatology 38:826–830
Rozboril MB, Maricq HR, Rodnan GP et al (1983) Capillary microscopy in eosinophilic fasciitis. A comparison with systemic sclerosis. Arthritis Rheum 26:617–622
Zaric D, Worm AM, Stahl D et al (1981) Capillary microscopy of the nailfold in psoriatic and rheumatoid arthritis. Scand J Rheumatol 10:249–252
Grassi W, Core P, Carlino G et al (1992) Nailfold capillary permeability in psoriatic arthritis. Scand J Rheumatol 21:226–230
Dinc A, Melikoglu M, Korkmaz C et al (2001) Nailfold capillary abnormalities in patients with familial Mediterranean fever. Clin Exp Rheumatol 19(Suppl 24):S42–S44
Vaiopoulos G, Pangratis N, Samarkos M et al (1995) Nailfold capillary abnormalities in Behçet’s disease. J Rheumatol 22:1108–1111
Sulli A, Pizzorni C, Cutolo M (2000) Nailfold videocapillaroscopy in patients with antiphospholipid antibodies. J Rheumatol 27:1574–1576
Grassi W, Core P, Carlino G et al (1994) Capillary permeability in fibromyalgia. J Rheumatol 21:1328–1331
Fahrig C, Heidrich H, Voigt B et al (1995) Capillary microscopy of the nailfold in healthy subjects. Int J Microcirc Clin Exp 15:287–292
Herrick AL, Moore T, Hollis S et al (2000) The influence of age on nailfold capillary dimensions in childhood. J Rheumatol 27:797–800
Merlen JF (1985) Capillaroscopy at the nailbed in functioning people aged 70 and over. Int Angiol 4:285–288
Michoud E, Poensin D, Carpentier PH (1994) Digitized nailfold capillaroscopy. Vasa 23:35–42
Bukhari M, Hollis S, Moore T et al (2000) Quantitation of microcirculatory abnormalities in patients with primary Raynaud’s phenomenon and systemic sclerosis by video-capillaroscopy. Rheumatology 39:506–512
Anderson ME, Allen PD, Moore T et al (2005) Computerized nailfold videocapillaroscopy. A new tool for assessment of Raynaud’s phenomenon. J Rheumatol 32:841–848
Leteurtre E, Hachulla E, Janin A et al (1994) Vascular manifestations of dermatomyositis and polymyositis: clinical, capillaroscopic and histological aspects. Rev Med Interne 15:800–807
De Angelis R, Bugatti L, Del Medico P et al (2002) Videocapillaroscopic findings in the microcirculation of the psoriatic plaque. Dermatology 204:236–239
Chang CH, Tsai RK, Wu WC et al (1997) Use of dynamic capillaroscopy for studying cutaneous microcirculation in patients with diabetes mellitus. Microvasc Res 53:121–127
Monticone G, Colonna L, Palermi G et al (2000) Quantitative nailfold capillary microscopy findings in patients with acrocyanosis compared with patients having systemic sclerosis. J Am Acad Dermatol 42:787–790
Fitzgerald O, C’Connor GT, Spencer-Green G (1988) Prospective study on the evolution of Raynaud’s phenomenon. Am J Med 84:718–726
Spencer-Green G (1998) Outcomes in primary Raynaud’s phenomenon. A meta-analysis of frequency, rates and predictors of transition to secondary disease. Arch Intern Med 158:595–600
Luggen M, Belhorn L, Evans T et al (1995) The evolution of Raynaud’s phenomenon: a longterm prospective study. J Rheumatol 22:2226–2232
Maricq HR, Harper FE, Khan MM et al (1983) Microvascular abnormalities as possible predictors of disease subsets in Raynaud’s phenomenon and early connective tissue disease. Clin Exp Rheumatol 1:195–205
ter Borg EJ, Piersma-Wichers G, Smit AJ et al (1994) Serial nailfold capillary microscopy in primary Raynaud’s phenomenon and scleroderma. Semin Arthritis Rheum 24:40–47
Bredemeier M, Xavier RM, Capobianco KG et al (2004) Nailfold capillary microscopy can suggest pulmonary disease activity in systemic sclerosis. J Rheumatol 31:286–294
Kabasakal Y, Elvins DM, Ring EFJ et al (1996) Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls. Ann Rheum Dis 55:507–512
Cutolo M, Pizzorni C, Tuccio M et al (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology 43:719–726
Jayson MIV (1984) The microcirculation in systemic sclerosis. Clin Exp Rheumatol 2:85–91
Wigley FM, Wise RA, Miller R et al (1992) Anticentromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis. Arthritis Rheum 35:688–693
Grassi W, Core P, Carlino G et al (1994) Effects of peripheral cold exposure on microvascular dynamics in systemic sclerosis. Arthritis Rheum 37:384–390
Filaci G, Cutolo M, Scudeletti M et al (1999) Cyclosporin A and iloprost treatment of systemic sclerosis: clinical results and interleukin-6 serum changes after 12 months of therapy. Rheumatology 38:992–996
Faggioli P, Giani L, Mazzone A (2006) Possibile role of iloprost (stable analogue of PGI2) in promoting neoangiogenesis in systemic sclerosis. Clin Exp Rheumatol 24:220
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Grassi, W., De Angelis, R. Capillaroscopy: questions and answers. Clin Rheumatol 26, 2009–2016 (2007). https://doi.org/10.1007/s10067-007-0681-3
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DOI: https://doi.org/10.1007/s10067-007-0681-3