The usefulness of nailfold capillaroscopy in 'scleroderma-spectrum' disorders

Nailfold capillaroscopy is a non-invasive method for visualising the nailfold capillaries under a stereomicroscope or videocapillaroscope. The examination is used for differential diagnosis of Raynaud`s phenomenon and microcirculation disorders in secondary Raynaud’s phenomenon associated with systemic connective tissue diseases [1]. Capillaroscopy is particularly important for early diagnosis of systemic sclerosis (SSc) for assessing the disease activity and the extent of internal organ involvement as well as for monitoring and evaluating the effectiveness of the therapy applied. In SSc, the capillaroscopic examination shows characteristic microcirculation disturbance called microangiopathy typical of SSc “scleroderma pattern”. The term microangiopathy includes the following pathological changes: dilated capillary loops leading to formation of megacapillaries, decreased numbers of vessels, the areas of avascularisation, and the presence of ramified loops and microhaemorrhages [2].