Role of dermoscopy in detection of nailfold capillaroscopic changes in autoimmune connective tissue diseases

Document Type : Original Article

Authors

1 Department of Dermatology,Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt.

2 Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Egypt.

3 Department of Internal Medicine and Rheumatology, Faculty of Medicine, Alexandria University.

4 Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Egypt.

Abstract

Background: Nail fold capillaries abnormalities are characteristic in some autoimmune connective tissue diseases. Recently, handheld dermoscope can be used to detect these abnormalities.
Aim of the study: To evaluate the nail fold capillaries pattern in different autoimmune connective tissue diseases using handheld dermoscope. Moreover, the relation between morphologic abnormalities and disease duration, activity, and severity were attempted.
Patients and Methods: This cross-sectional study was carried out over a period of six months on patients presenting to outpatient clinics of Alexandria main University hospital diagnosed with autoimmune connective tissue diseases. Sixty-seven females were included and were further categorized according to their primary connective tissue diseases. Disease specific markers and disease activity were assessed. Capillaroscopy was performed using DermLite® DL4 pocket dermoscope.
Results: The scleroderma pattern was detected in 100% of scleroderma and dermatomyositis, 71.4% of mixed connective tissue disease, 65.2 % of rheumatoid arthritis, and 52.9 % of systemic lupus erythematosus patients. There was a statistically significant relation between systemic lupus erythematosus disease activity index and abnormal morphology. There was no statistically significant relation between dermoscopic findings and any other disease activity markers, patients’ age, or disease duration.
Conclusion/ recommendations: Dermoscopy is a helpful tool in assessment of nail fold capillaries abnormalities in autoimmune connective tissue diseases. Furthermore, in SLE patients, as abnormal morphology correlates with disease activity, dermoscopy could be a suitable screening test.

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