Videocapillaroscopy of nail bed in systemic scleroderma: prognostic and diagnostic value
Journal Title: Серце і судини - Year 2019, Vol 0, Issue 3
Abstract
Videocapillaroscopy (VCS) is a unique method of morphological assessment of capillaries of the nail bed which is characterized by the ease and speed of execution, plays a crucial role in the early diagnosis of systemic scleroderma (SSD). The first description of pathological capillaroscopic changes in SSD was made in 1925. Decades later, they were validated and accepted as one of the diagnostic criteria in 2013 EULAR/ACR SSD classification criteria. Data are presented about the use of VCS of the nail bed in SSD. Three sclerodermal patterns have been identified: «early», «active» and «late» which reflect the evolution of capillaroscopic changes, suggesting their correlation with the duration of the disease. Current knowledge of microvascular anomalies in SSD confirms the association of vascular changes in VCS not only with duration but also with disease activity. Expert opinion is mixed about the association of VCS results with the clinical picture and involvement of organs and systems. The rate of progression of microvascular changes can be a crucial criterion for diagnosis, and in the case of rapid dynamics of capillaroscopic SSD‑associated patterns, they can be considered as an indicator of disease activity. Normalization of capillaroscopic changes in the vessels of the nail bed was observed after treatment with immunosuppressants, transplantation of hematopoietic stem cells and the use of an endothelin receptor antagonist — bosentan. The further development of knowledge about VCS of the nail bed in SSD will facilitate a wider use of this informative, non‑invasive diagnostic tool as a reliable method for assessing disease activity, prognosis, and therapeutic response.
Authors and Affiliations
I. Y. Golovach, Y. D. Yehudina
Keywords
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- EP ID EP673901
- DOI 10.30978/HV2019-3-67
- Views 147
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