scholarly journals Nailfold videocapillaroscopy in internal medicine

2015 ◽  
Vol 9 (3) ◽  
pp. 234 ◽  
Author(s):  
Paola Faggioli ◽  
Antonio Tamburello ◽  
Alba Sciascera ◽  
Adele Giulia Gilardi ◽  
Antonino Mazzone
Keyword(s):  
Internal Medicine ◽  
Systemic Sclerosis ◽  
Gold Standard ◽  
Imaging Technique ◽  
Raynaud’S Phenomenon ◽  
Nailfold Capillaroscopy ◽  
Nailfold Videocapillaroscopy ◽  
Standard Methods ◽  
Non Invasive ◽  
Rheumatologic Diseases

Capillaroscopy is an actual inexpensive imaging technique, used to examine, non-invasively and safely, the morphology of nailfold dermal papillary capillaries. Many studies agree in the statement that the capillaroscopy is one of the gold standard methods for non-invasive examination of the microcirculation and it plays an important role in screening in Raynaud’s phenomenon and in monitoring of systemic sclerosis and other rheumatologic diseases. There are also many reports on the possible use of nailfold capillaroscopy in the diagnosis and monitoring of many other diseases in internal medicine.

scholarly journals Clinical relevance of combining Thermography with Nailfold Capillaroscopy to improve differentiation between primary and secondary Raynaud’s Phenomenon

2021 ◽  
pp. 39-48
Author(s):  
Yumiko Vreeburg ◽  
Laura van Vugt ◽  
Sabrina Simonnet ◽  
Daphne Valk ◽  
Gus Schardijn ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vascular Function ◽  
Raynaud’S Phenomenon ◽  
Challenge Test ◽  
Raynaud's Phenomenon ◽  
Nailfold Capillaroscopy ◽  
Invasive Technique ◽  
Microvascular Damage ◽  
Non Invasive ◽  
Age Related

Objectives: Early microvascular damage and dysfunction are clinically mirrored in Raynaud’s phenomenon (RP). Currently, nailfold capillaroscopy (NC) is applied to differentiate between primary RP (PRP) and secondary RP (PRP), associated with connective tissue disease. However, abnormal morphology can also be caused due to age-related changes and cardiovascular disease. Thermography (TG) is a non-invasive technique which enables quantification of cutaneous vascular function. An approach using both NC and TG could improve the differentiation between PRP and SRP. Methods: Thirty RP patients (PRP, n = 21; SRP, n = 9) underwent nailfold capillaroscopy and thermography. Morphologic features were scored and patients were categorized according to the guidelines of EULAR Study group on Microcirculation in Rheumatic Diseases. TG of the hand was performed before, directly and ten minutes after a cold challenge test. Baseline images and rewarming curves were analyzed. Results: Capillary abnormalities with NC were found in all SRP patients (9/9) and in 48% (10/21) of PRP patients. Out of 10 PRP patients with altered capillary morphology, 9 (90%) had a cardiovascular disease. For all patients mean temperature was significantly higher 10 minutes after cold induction than before (p < 0,01). The gradient of the rewarming curve was significantly lower in patients with SRP compared to PRP patients (p = 0.015). Conclusions: Nailfold capillaroscopy and thermography can reliably be used to measure microvascular damage and dysfunction. Additional thermography can assist in differentiating between PRP and SRP, especially in elderly patients or in presence of a cardiovascular disease. Keywords: Raynaud’s phenomenon; Nailfold capillaroscopy; Thermography

scholarly journals Microvascular damage evaluation in systemic sclerosis: the role of nailfold videocapillaroscopy and laser techniques

Reumatismo ◽  
2017 ◽  
Vol 69 (4) ◽  
pp. 147 ◽  
Author(s):  
B. Ruaro ◽  
A. Sulli ◽  
V. Smith ◽  
C. Pizzorni ◽  
S. Paolino ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Peripheral Blood ◽  
Imaging Technique ◽  
Blood Perfusion ◽  
Clinical Aspects ◽  
Damage Evaluation ◽  
Nailfold Videocapillaroscopy ◽  
Microvascular Damage ◽  
Laser Technologies

Microvascular damage and a decrease in peripheral blood perfusion are typical features of systemic sclerosis (SSc) with serious clinical implications, not only for a very early diagnosis, but also for disease progression. Nailfold videocapillaroscopy is a validated and safe imaging technique able to detect peripheral capillary morphology, as well as to classify and to score any nailfold abnormalities into different microangiopathy patterns. Capillaroscopic analysis is now included in the ACR/EULAR classification criteria for SSc. The decrease in peripheral blood perfusion is usually associated with microvascular damage in SSc, which may be studied by different methods. Several of these make use of safe laser technologies. This paper focuses on these new clinical aspects to assess SSc microvascular impairment.

scholarly journals Nailfold capillaroscopic findings in patients with Raynaud’s phenomenon: Preliminary report

2015 ◽  
Vol 4 (1) ◽  
pp. 13-15
Author(s):  
Binit Vaidya ◽  
Manisha Bhochhibhoya
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Rheumatic Diseases ◽  
Morphological Changes ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Primary Diagnosis ◽  
Nailfold Capillaroscopy ◽  
Future Evolution ◽  
Non Invasive

Back grounds and Aims: Microvascular involvement of nailfold often occurs in systemic rheumatic diseases, especially scleroderma and related conditions. Nailfold capillaroscopy is easily performed non-invasive, simple, repeatable, sensitive, safe and inexpensive method to examine nailfold architecture by microscope.The normal capillaries are thin, symmetrical and have hair-pin appearance. Anomalies include dilated capillary loops, dropouts, tortuosity, avascular area, arborifications, megacapillaries, infracts,thrombsis and haemorrhages. This study aims to see the morphological changes in microcirculation in nailfolds of patients with Raynaud’s, which can be helpful in predicting the presence of connective tissue disorder.Methods: It is an observational study conducted at National Center for Rheumatic Diseases, Kathmandu from 26th March 2014 to 30th March 2015. Nailfolds of 8 fingers of both hands in 105 patients were examined using a hand held microscope.Results: Of 105 patients, 91 patients (86.6%) had abnormal morphological changes while 14 (13.4%) had no significant changes in microvessels. Normal patients had no underlying connective tissue disease(CTD) but those with abnormal findings had proven underlying CTD which included Lupus 6.5%, Scleroderma 17.5%, Rheumatoid Arthritis 14.2%, Mixed CTD7.6%, Undifferentiated CTD1.0%, Undifferentiated inflammatory arthritis 14.2%, Psorasis 1.0%, Rheumatoid Arthritis with scleroderma overlap 4.3%. No primary diagnosis was found in 32.9% of patients.Conclusion: Nailfold capillaroscopy allows direct examination of microvascular structure of a patient. Abnormal findings in a patient with Raynaud’s phenomenon might help to identify the presence of or future evolution into systemic connective tissue disorder.Journal of Advances in Internal Medicine 2015;04(01):13-15

scholarly journals POS1408 REPRODUCIBILITY OF A NEW AUTOMATIC SYSTEM (CAPILLARY.IO) IN THE ANALYSIS OF NAILFOLD CAPILLAROSCOPY IMAGES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 987.1-987
Author(s):  
B. Gracia Tello ◽  
E. Ramos ◽  
C. P. Simeón-Aznar ◽  
V. Fonollosa Pla ◽  
A. Guillén-Del-Castillo ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Sensitivity And Specificity ◽  
Gold Standard ◽  
Automatic System ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Nailfold Capillaroscopy ◽  
Invasive Technique ◽  
Microvascular Damage ◽  
Predictive Values

Background:Nailfold Capillaroscopy is a simple, inexpensive and non-invasive technique that allows microvascular damage to be observed, gaining recent importance in the diagnosis, monitoring and prognosis of many diseases with microangiopathy. However, the variability in the results interpretation has led to the development of new computerized systems that allow the automatic analysis of capillaroscopic images.Objectives:to compare the degree of agreement between the automatic system Capillary.io and a gold standard obtained from the agreement of 9 expert capillaroscopists and to know the degree of the interobserver reliability To demonstrate the validity of the system to detect normal and enlarged capillaries, hemorrhages, megacapillaries, ramifications and tortuosities.Methods:a cross-sectional study was performed in which 300 random and anonymous nailfold capillaroscopic images (1165 capillaries) were analyzed by 9 experienced observers. The degree of interobserver agreement was calculated from the 5 users. Likewise, the system performed an automatic assessment of the images and their agreement with the gold standard was calculated (interobserver agreement greater than 5, 6, 7, 8 and 9 successively). The validity of the program for each variable was also analyzed using sensitivity and specificity, positive and negative predictive values, and likelihood ratios, as well as their degree of agreement using the weighted kappa statistic (95% CI, p <0.05). The programs used for statistical calculations were SPSS 22.0 and EPIDAT 3.0.Results:the degree of interobserver agreement was 76.5% for the agreement of 5 or more observers, progressively decreasing to 15.4% for the 9 observers. Capillary.io obtained higher levels of agreement, reaching 97.7% for the 9 observers. Statistically significant results were obtained in the automated detection of all the morphological alterations analyzed Capillary.io presented a sensitivity (S) of 79.82% and a specificity (E) of 82% in the recognition of normal capillaries. The automatized system was able to recognize enlarged capillaries with a sensitivity of 86.97% and a specificity of 81.38%. Megacapillaries were detected with 89.41% sensitivity and 78.75% specificity. Similarly, the system was able to detect tortuosities (S 66.94%; E 67.71%), ramifications (S 54.34%; E 58.61%) and hemorrhages (S 71.36; E 73.97%).Conclusion:Capillary.io demonstrated a high degree of agreement with the gold standard, stronger with greater consensus among observers. It was able to detect with great sensitivity and specificity hemorrhages and megacapillaries, very relevant alterations in microangiopathies.References:[1]Roldán LMC, Franco CJV, Navas MAM. Capillaroscopy in systemic sclerosis: A narrative literature review. Rev Colomb Reumatol; 2016; 23: 250-8.[2]Ingegnoli F, Gualtierotti R, Lubatti C, Bertolazzi C, Gutierrez M, Boracchi P, et al. Nailfold capillary patterns in healthy subjects: A real issue in capillaroscopy. Microvasc Res. 2013;90:90-5.[3]Cutolo M, Pizzorni C, Secchi ME, Sulli A. Capillaroscopy. Best Pract Res Clin Rheumatol. 2008; 22:1093-108.[4]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Res Int. 2015; 2015: 974530.[5]Smith V, Herrick AL, Ingegnoli F, Damjanov N, De Angelis R, Denton CP, et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmunity Reviews. 2020; 19: 102458.Disclosure of Interests:Borja Gracia Tello Shareholder of: Co-founder and shareholder of Capillary.io., Eduardo Ramos Shareholder of: Co-founder and shareholder of Capillary.io., Carmen Pilar Simeón-Aznar: None declared, Vicent Fonollosa Pla: None declared, Alfredo Guillén-Del-Castillo: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared

scholarly journals FRI0257 CAPILLAROSCOPIC VERY EARLY MORPHOLOGICAL AND QUANTITATIVE SPECIFIC ABNORMALITIES ANTICIPATE THE DEVELOPMENT OF THE “SCLERODERMA PATTERN” IN PATIENTS WITH RAYNAUD’S PHENOMENON

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 712.2-713
Author(s):  
M. Pendolino ◽  
C. Pizzorni ◽  
S. Paolino ◽  
F. Goegan ◽  
E. Gotelli ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Apical Region ◽  
Nailfold Videocapillaroscopy ◽  
Research Support ◽  
Microvascular Damage ◽  
First Time ◽  
Present Pilot Study ◽  
Scleroderma Pattern

Background:Nailfold videocapillaroscopy (NVC) abnormalities in subjects with isolated Raynaud’s phenomenon (RP) may be present before transition to secondary RP(SRP) and development of a NVC “scleroderma pattern” and are known to predict for evolution to a connective tissue disease (CTD) within few years [1]. In a previous study, we have demonstrated that the very early increase of capillary diameter over 30 μm is an independent predictor for development of Systemic Sclerosis (SSc) associated SRP [2].Objectives:Present pilot retrospective study aimed to investigate in a cohort of patients affected by CTD–related RP the presence of very early capillaroscopic morphological and quantitative abnormalities in the acquired pictures of NVC performed before the development of the NVC scleroderma-pattern. In particular, the study was addressed to identify a “very early”scleroderma pattern, in order to intercept patients with RP at high risk of evolution in a CTD, specifically SSc.Methods:We selected the NVCs of 273 SSc patients presenting one of the validated NVC “scleroderma patterns”. We enrolled 26 SSc patients having a NVC analysis performed before the development ofthe “very early”NVC pattern. As controls, we evaluated 26 patients affected by other CTDs with stable non-scleroderma pattern over time. The 16 images per patient obtained by NVC examination were analyzed for total number of capillaries, number and the limbs diameters of capillaries with a diameter >30 μm, and microhemorrhages. Statistical analysis was performed using non-parametric tests.Results:All 26 SSc patients showed dilated capillaries with a diameter >30 μm in their previous NVC. Patients later developing scleroderma pattern had statically higher number and percentage of capillaries with a diameter >30 μm (p=0.0004 and p=0.0005), as well as a larger apical dilatation >40 μm (p=0.002). A progressive and significant increase in all capillary diameters were only detected in patients later diagnosed for SSc (apical p=0.006, venous p=0.02, arterial p=0.03). A significant homogeneous and progressive dilation was observed from the apical region and then involving both venous and arterial branches, only in SSc patients (p=0.002).Conclusion:Present pilot study demonstrates, for the first time that, before to develop a validated NVC scleroderma-pattern, all potential SSc patients present significant very early morphological and quantitative NVC changes. In particular, the progressive and homogeneous capillary loop dilation over 40 μm in over 40% of total number capillaries significantly could contribute to identify RP patients who will develop a SSc pattern after 4-5 years.References:[1]Cutolo M, Sulli A, Pizzorni C, Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000;27:155-60.[2]Trombetta AC, et al. J Rheumatol 2016;43:599-606.Disclosure of Interests:Monica Pendolino: None declared, Carmen Pizzorni: None declared, Sabrina Paolino: None declared, Federica Goegan: None declared, Emanuele Gotelli: None declared, Carlotta Schenone: None declared, Francesco Cattelan: None declared, Massimo Patanè: None declared, Elisa Alessandri: None declared, Alberto Sulli Grant/research support from: Laboratori Baldacci, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha

scholarly journals Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated?

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Mahnaz Etehad Tavakol ◽  
Alimohammad Fatemi ◽  
Abdolamir Karbalaie ◽  
Zahra Emrani ◽  
Björn-Erik Erlandsson
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Raynaud’S Phenomenon ◽  
Nailfold Capillaroscopy ◽  
Classification Criterion ◽  
Clinical Practices ◽  
Main Indication ◽  
Monitoring Therapy

Video nailfold capillaroscopy (NFC), considered as an extension of the widefield technique, allows a more accurate measuring and storing of capillary data and a better defining, analyzing, and quantifying of capillary abnormalities. Capillaroscopic study is often performed on the patients suspected of having microcirculation problems such as Raynaud’s phenomenon as the main indication for nailfold capillaroscopy. Capillaroscopic findings based on microcirculation studies can provide useful information in the fields of pathophysiology, differential diagnosis, and monitoring therapy. Nailfold capillaroscopy provides a vital assessment in clinical practices and research; for example, its reputation in the early diagnosis of systemic sclerosis is well established and it is also used as a classification criterion in this regard. This review focuses on the manner of performing video nailfold capillaroscopy and on a common approach for measuring capillary dimensions in fingers and toes.

scholarly journals Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis

2020 ◽  
Vol 19 (3) ◽  
pp. 102458 ◽  
Author(s):  
Vanessa Smith ◽  
Ariane L. Herrick ◽  
Francesca Ingegnoli ◽  
Nemanja Damjanov ◽  
Rossella De Angelis ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Nailfold Capillaroscopy
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