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Rheumatologists Find Nailfold Capillaroscopy an Increasingly Useful Diagnostic Tool

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Hopefully, nailfold capillaroscopy will allow researchers to assess whether early interventions with available vascular remodeling drugs may be able to help prevent disease progression in early SSc.8 As new drugs become available, videocapillaroscopy in particular may provide a powerful research tool to help assess treatment response at all stages of disease for this illness that is currently so difficult to treat.

Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.

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References

  1. Criveanu C, Ciurea PL, Musetescu AE, et al. Capillaroscopy—a valuable tool for the assessment of vascular impairment in systemic sclerosis. Romanian Journal of Rheumatology. 2016;25(3):112–116.
  2. Chojnowski MM, Felis-Giemza A, Olesińska M. Capillaroscopy—a role in modern rheumatology. Reumatologia. 2016;54(2):67–72. doi:10.5114/reum.2016.60215.
  3. Smith V, Thevissen K, Trombetta AC, et al. Nailfold capillaroscopy and clinical applications in systemic sclerosis. Microcirculation. 2016 Jul;23(5):364–372. doi:10.1111/micc.12281.
  4. Sood I, Dadhaniya N, Upadhyaya SK, et al. Nailfold capillaroscopy—an underutilised investigation in rheumatology. Apollo Medicine. 2017;14:21–26.
  5. Roldán LMC, Franco CJV, Navas MAM, et al. Capillaroscopy in systemic sclerosis: A narrative literature review. Rev Colmb Reumatol. 2016;23(4):250–258.
  6. Dogan S, Akdogan A, Atakan N. Nailfold capillaroscopy in systemic sclerosis: Is there any difference between videocapillaroscopy and dermatoscopy? Skin Res Technol. 2013 Nov;19(4):446–449. doi:10.1111/srt.12067.
  7. Linnemann B, Erbe M. Raynaud’s phenomenon—assessment and differential diagnoses. Vasa. 2015 May;44(3):166–177. doi:10.1024/0301-1526/a000426.
  8. Herrick AL, Cutolo M. Clinical implications from capillaroscopic analysis in patients with Raynaud’s phenomenon and systemic sclerosis. Arthritis Rheum. 2010 Sep;62(9):2595–2604. doi:10.1002/art.27543.
  9. Koenig M, Joyal F, Fritzler MJ, et al. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud’s phenomenon to systemic sclerosis: A twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum. 2008 Dec;58(12):3902–3912.
  10. Ingegnoli F, Boracchi P, Gualtierotti R, et al. Prognostic model based on nailfold capillaroscopy for identifying Raynaud’s phenomenon patients at high risk for the development of a scleroderma spectrum disorder: PRINCE (prognostic index for nailfold capillaroscopic examination). Arthritis Rheum. 2008 Jul;58(7):2174–2182. doi:10.1002/art.23555.
  11. Cutolo M, Sulli A, Pizzorni C, Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000 Jan;27(1):155–160.
  12. Ingegnoli F, Smith V, Sulli A, Cutolo M. Capillaroscopy in routine diagnostics: Potentials and limitations. Curr Rheumatol Rev. 2017 Jun 14. doi:10.2174/1573397113666170615084229.
  13. Cutolo M, Ruaro B, Pizzorni C, et al. Longterm treatment with endothelin receptor antagonist bosentan and iloprost improves fingertip blood perfusion in systemic sclerosis. J Rheumatol. 2014 May;41(5):881–886.
  14. Trombetta AC, Pizzorni C, Ruaro B, et al. Effects of longterm treatment with bosentan and iloprost on nailfold absolute capillary number, fingertip blood perfusion, and clinical status in systemic sclerosis. J Rheumatol. 2016 Nov;43(11):2033–2041.
  15. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Ann Rheum Dis. 2013 Nov;72(11):1747–1755. doi:10.1136/annrheumdis-2013-204424.
  16. Jordan S, Maurer B, Toniolo M, et al. Performance of the new ACR/EULAR classification criteria for systemic sclerosis in clinical practice. Rheumatology (Oxford). 2015 Aug;54(8):1454–1458. doi:10.1093/rheumatology/keu530.
  17. Hatzis C, Lerner D, Paget S, et al. Integration of capillary microscopy and dermoscopy into the rheumatology fellow curriculum. Clin Exp Rheumatol. 2017 Feb 10. [Epub ahead of print]

About Ruth Jessen Hickman, MD

Ruth Jessen Hickman, MD, was born and raised in eastern Kentucky, where she first cultivated her love of literature, writing and personal narratives. She attended Kenyon college, where she received a Bachelor of Arts in philosophy, summa cum laude. She worked with individuals with psychiatric conditions and later in a neuroscience lab at the University of Illinois, Chicago, before graduating from Indiana University Medical School in 2011. Instead of pursuing clinical medicine, Ruth opted to build on her strength of clearly explaining medical topics though a career as a freelance medical writer, writing both for lay people and for health professionals. She writes across the biomedical sciences, but holds strong interests in rheumatology, neurology, autoimmune diseases, genetics, and the intersection of broader social, cultural and emotional contexts with biomedical topics. Ruth now lives in Bloomington, Ind., with her husband, son and cat. She can be contacted via her website at ruthjessenhickman.com.

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