Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis

Objective To investigate and distinguish detailed nailfold videocapillaroscopy (NVC) findings in patients with limited (lcSSc) and diffuse (dcSSc) cutaneous systemic sclerosis (SSc).Methods A total of 157 patients was recruited, 100 with lcSSc, 27 with dcSSc and 30 with primary Raynaud phenomenon (p...

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Main Authors: Sabrina Paolino, Vanessa Smith, Maurizio Cutolo, Alberto Sulli, Carmen Pizzorni, Emanuele Gotelli, Rosanna Campitiello, Ana Margarida Correia
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/3/e005716.full
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author Sabrina Paolino
Vanessa Smith
Maurizio Cutolo
Alberto Sulli
Carmen Pizzorni
Emanuele Gotelli
Rosanna Campitiello
Ana Margarida Correia
author_facet Sabrina Paolino
Vanessa Smith
Maurizio Cutolo
Alberto Sulli
Carmen Pizzorni
Emanuele Gotelli
Rosanna Campitiello
Ana Margarida Correia
author_sort Sabrina Paolino
collection DOAJ
description Objective To investigate and distinguish detailed nailfold videocapillaroscopy (NVC) findings in patients with limited (lcSSc) and diffuse (dcSSc) cutaneous systemic sclerosis (SSc).Methods A total of 157 patients was recruited, 100 with lcSSc, 27 with dcSSc and 30 with primary Raynaud phenomenon (pRP). The NVC SSc pattern and the absolute number of capillaries (per linear millimetre) were performed at the first NVC analysis. ‘Early’/‘Active’ NVC status (capillary dilations, microhaemorrhages and giant capillaries) and ‘Late’ NVC status (number of capillaries, altered microvascular architecture and abnormal capillary shapes) were scored.Results A statistically significant difference in the absolute number of capillaries between patients with lcSSc, dcSSc and pRP was found (p<0.001). Capillary number loss was present in both SSc subgroups and it was significantly higher in patients with dcSSc compared with lcSSc (4.89±1.53 vs 6.18±1.75, p<0.001). A significantly higher ‘Late’ NVC status score was observed in patients with dcSSc (p<0.001), including lower capillary density (p<0.001), altered shapes (p<0.001) and presence of abnormal shapes (p=0.005). Correlations showed that higher modified Rodnan Skin Score is associated with decreased capillary number and higher ‘Late’ NVC status score (p<0.001). Additionally, a statistically significant association was established between ‘Late’ SSc pattern and dcSSc (p=0.004) and between ‘Early’ SSc pattern and lcSSc (p=0.010). The absolute capillary number was normal and significantly higher in patients with pRP (p<0.001) than in all patients with SSc.Conclusions The current investigation underlines the importance of NVC detailed analysis and scoring in discriminating the severity of microvascular damage between lcSSc and dcSSc.
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spelling doaj-art-e88488b1c9b448e79541de2fbe6697a42025-08-20T03:30:09ZengBMJ Publishing GroupRMD Open2056-59332025-07-0111310.1136/rmdopen-2025-005716Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysisSabrina Paolino0Vanessa Smith1Maurizio Cutolo2Alberto Sulli3Carmen Pizzorni4Emanuele Gotelli5Rosanna Campitiello6Ana Margarida Correia7Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyRheumatology and Internal Medicine, Ghent University, Ghent, BelgiumLaboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyLaboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyLaboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyLaboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyLaboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, ItalyRheumatology Department, Unidade Local de Saúde de Braga, Braga, PortugalObjective To investigate and distinguish detailed nailfold videocapillaroscopy (NVC) findings in patients with limited (lcSSc) and diffuse (dcSSc) cutaneous systemic sclerosis (SSc).Methods A total of 157 patients was recruited, 100 with lcSSc, 27 with dcSSc and 30 with primary Raynaud phenomenon (pRP). The NVC SSc pattern and the absolute number of capillaries (per linear millimetre) were performed at the first NVC analysis. ‘Early’/‘Active’ NVC status (capillary dilations, microhaemorrhages and giant capillaries) and ‘Late’ NVC status (number of capillaries, altered microvascular architecture and abnormal capillary shapes) were scored.Results A statistically significant difference in the absolute number of capillaries between patients with lcSSc, dcSSc and pRP was found (p<0.001). Capillary number loss was present in both SSc subgroups and it was significantly higher in patients with dcSSc compared with lcSSc (4.89±1.53 vs 6.18±1.75, p<0.001). A significantly higher ‘Late’ NVC status score was observed in patients with dcSSc (p<0.001), including lower capillary density (p<0.001), altered shapes (p<0.001) and presence of abnormal shapes (p=0.005). Correlations showed that higher modified Rodnan Skin Score is associated with decreased capillary number and higher ‘Late’ NVC status score (p<0.001). Additionally, a statistically significant association was established between ‘Late’ SSc pattern and dcSSc (p=0.004) and between ‘Early’ SSc pattern and lcSSc (p=0.010). The absolute capillary number was normal and significantly higher in patients with pRP (p<0.001) than in all patients with SSc.Conclusions The current investigation underlines the importance of NVC detailed analysis and scoring in discriminating the severity of microvascular damage between lcSSc and dcSSc.https://rmdopen.bmj.com/content/11/3/e005716.full
spellingShingle Sabrina Paolino
Vanessa Smith
Maurizio Cutolo
Alberto Sulli
Carmen Pizzorni
Emanuele Gotelli
Rosanna Campitiello
Ana Margarida Correia
Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
RMD Open
title Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
title_full Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
title_fullStr Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
title_full_unstemmed Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
title_short Differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis: a detailed analysis
title_sort differences in nailfold capillaroscopy findings between limited and diffuse cutaneous systemic sclerosis a detailed analysis
url https://rmdopen.bmj.com/content/11/3/e005716.full
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