NAILFOLD CAPILLAROSCOPY ABNORMALITIES CORRELATE WITH CUTANEOUS AND VISCERAL INVOLVEMENT IN SYSTEMIC SCLEROSIS PATIENTS

摘要

Objective: The aim of this study was to correlate quantitative and semiquantitative nailfold capillaroscopy (NFC) parameters with the extent of cutaneous and visceral involvement in systemic sclerosis (SSc) patients. Methods: The presence of clinical and serological alterations was evaluated retrospectively and correlated with NFC findings (number of capillary loops/mm, vascular deletion score and number of enlarged and giant capillary loops). For evaluation of disease extension five manifestations were analyzed: finger pad lesions, skin involvement, esophageal involvement, interstitial lung disease, and pulmonary hypertension. Results: There were 105 NFC examinations in 92 patients, 13 of whom were evaluated at two different time points. Patients with diffuse cutaneous SSc had a higher vascular deletion score than patients with limited cutaneous SSc, sine scleroderma SSc, and overlap syndrome (1.67 +/- 0.91 vs 0.99 +/- 0.82; p=0.0005). Modified Rodnan's skin score correlated positively with capillary deletion, evaluated by the vascular deletion score and the number of capillary loops/mm (p<0.001 and p=0.012; respectively). Patients with three or more involved tracts presented lower number of capillary loops/mm (8.00 +/- 1.69 vs 9.23 +/- 1.31 capillary loops/mm; p=0.025) and a higher vascular deletion score (1.41 +/- 0.95 vs 0.73 +/- 0.76; p=0.027) when compared to patients with less than three affected tracts. Vascular deletion score was higher in patients with anti-Scl-70 antibodies that in patients without anti-Scl-70 antibodies (p=0.02). Conclusions: NFC abnormalities correlated positively with the diffuse form of SSc, the degree of cutaneous involvement, the number of affected tracts, and the presence of anti-Scl-70 antibodies.