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Nailfold capillary changes in adult new-onset dermatomyositis: a prospective cross-sectional study

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Abstract

Objectives

It is to prospectively analyze nailfold capillaroscopy (NC) findings in new-onset dermatomyositis (DM) and to correlate NC findings with serum angiogenic cytokines and DM clinical and laboratory features.

Materials and methods

Twenty-three patients with DM who experienced < 12 months of symptoms were included in the study. To assess serum cytokine levels, 23 age-, sex-, and ethnicity-matched healthy volunteers were used. NC characteristics and DM activity parameters were analyzed.

Results

Significantly higher serum angiogenin (ANG) and vascular endothelial growth factor-1 (VEGF1) levels were observed in DM patients than in controls. Capillary density and avascular areas correlated positively and negatively, respectively, with serum levels of ANG. Moreover, the capillary density correlated inversely with the number of enlarged and giant capillaries and avascular areas. The number of enlarged capillaries correlated positively with patient and physician visual analogue scales (VAS), the presence of a facial rash, giant capillaries, and microhemorrhages. Giant capillaries had a positive correlation with physician and cutaneous VAS, enlarged capillaries, avascular areas, microhemorrhages and bushy capillaries, and a negative correlation with capillary density. Microhemorrhages correlated positively with the “V-neck” sign and physician VAS. VEGF1 showed no relationship with the NC parameters with DM-related clinical and laboratory features. Additionally, 15 out of 23 patients were assessed prospectively after 3.21 years. All patients had a major clinical response with significant improvement in all NC parameters, except for enlarged and bushy capillaries.

Conclusions

The NC may be a useful tool to assess disease activity in recent-onset DM, and it can also reinforce the role of ANG in the angiogenesis of this myopathy.

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Authors and Affiliations

  1. Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil

    Renata Miossi, Fernando Henrique Carlos de Souza & Samuel Katsuyuki Shinjo

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  1. Renata Miossi
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  2. Fernando Henrique Carlos de Souza
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  3. Samuel Katsuyuki Shinjo
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Correspondence to Samuel Katsuyuki Shinjo.

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The study was approved by the local ethics committee.

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Miossi, R., de Souza, F.H.C. & Shinjo, S.K. Nailfold capillary changes in adult new-onset dermatomyositis: a prospective cross-sectional study. Clin Rheumatol 38, 2319–2326 (2019). https://doi.org/10.1007/s10067-019-04537-x

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  • DOI: https://doi.org/10.1007/s10067-019-04537-x

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