Nail fold capillaroscopy differs widely between systemic sclerosis and chronic graft vs host disease of the skin.

摘要

Sir, Skin fibrosis is a common feature in patients with sclero-derma (SSc) or chronic graft vs host disease (cGvHD) after haemopoietic stem cell transplantation (HCST) with a relevant impact on quality of life. Despite the similarities in skin fibrosis, both diseases show several differences in their clinical manifestation.Nail fold capillaroscopy (NFC) is a simple and elegant tool to study microvascular architecture non-invasively. This well-established method is widely used in the diagnosis and follow-up of SSc patients [1]. In SSc, NFC reveals a severe disarrangement of capillaries, giant capillaries, atypical forms, microhaemorrhages and capillary rarefaction up to avascular fields differing quantitatively in the time course and depending on disease activity and therapy (Fig. 1). These morphological changes are described as scleroderma pattern. Very often, but not exclusively [2], this pattern is seen in patients with SSc. It reflects the microvascular aetiology of the disease. The role of vascular pathology in cGvHD is less well studied and much more controversial [3, 4]. The involvement of nail-fold capillaries by means of standard NFC has not yet been investigated.