ABSTRACT

Although determination of nailfold capillary changes is useful for the diagnosis of systemic sclerosis (SSc), the associations between capillaroscopic findings with clinical features are controversial. The aim of this study was to investigate the association of capillaroscopic scleroderma patterns with clinical features of SSc.

We studied 68 (female/male: 62/6) SSc patients. Medical records of the patients were reviewed retrospectively. Patients were categorized according to their capillaroscopy findings into 3 groups as having early, active or late scleroderma patterns. Demographic characteristics, clinical features and laboratory results of the patients were compared between the groups.

Twenty-eight (41.2%) patients had diffuse SSc. According to the nailfold capillaroscopy findings 23 (33.8%) patients had early scleroderma pattern, 24 (35.3%) active scleroderma pattern, and 18 (26.5%) late scleroderma pattern. Only 3 (4.4%) patients had normal capillaroscopy findings. The number of the patients with interstitial lung disease, pulmonary arterial hypertension or digital ulceration was not different between the groups (p>0.05, for all). The mean disease duration was longer in patients with late scleroderma pattern (11.8±7.8 years) as compared to patients with normal/early (6.5±3.7 years) and active (8.2±5.9 years) scleroderma patterns (p=0.016). The mean modified Rodnan skin score was also higher in patients with late scleroderma pattern (12.5±7.4) as compared to patients with normal/early (7.6±4.4) and active (7.5±4.4) scleroderma patterns (p=0.005). Anti-centromere antibody positivity was more frequent in patients with active (9 patients; 37.5%) scleroderma patterns as compared to patients with normal/early (2 patients; 7.7%) and late (1 patient; 5.6%) scleroderma patterns (p=0.01).

In this study severity of skin involvement was found to be associated with capillaroscopic late scleroderma pattern. Prospective studies are needed for defining the value of capillaroscopy findings in the follow-up of SSc patients accurately.