Pizzorni Carmen, Giampetruzzi Anna R, Mondino Chiara, Facchiano Antonio, Abeni Damiano, Paolino Sabrina, Ruaro Barbara, Smith Vanessa, Sulli Alberto, Cutolo Maurizio
Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS AOU San Martino-IST Genova, Italy.
Department of Dermatology, Dermoscopy and Nailfold Capillaroscopy Services, Istituto Dermopatico dell'Immacolata IDI-IRCCS FLMM, Rome, Italy.
Microvasc Res. 2017 May;111:20-24. doi: 10.1016/j.mvr.2016.12.003. Epub 2016 Dec 16.
To correlate nailfold capillaroscopic parameters with the presence of skin telangiectases (TAs) in systemic sclerosis patients (SSc).
Thirty-three consecutive patients (28 women and 5 men, mean age 59±21years) affected by SSc according to the ACR/EULAR criteria, 30 with limited (lcSSc) and 3 with diffuse (dcSSc) skin disease, displaying the presence of skin TAs on face, hands, forearms, neck, and décolleté were recruited. Nailfold videocapillaroscopy (NVC) was performed to classify the patients into one of the three main patterns of SSc microangiopathy ("early", "active", "late"), and to calculate the microangiopathy evolution score (MES). SSc patients underwent also dermoscopy (DS) for the analysis of the TA score and patterns (spot or reticular). Possible correlations between clinical findings, serum autoantibodies, TA patterns and both NVC patterns and MES were investigated.
The "late" NVC pattern was found associated with a highest total number of TAs (p=0.005): in particular both "spot" and "reticular" TA patterns were found equally distributed in SSc patients with the "late" pattern. High MES values were found associated with the highest total number of TAs (p=0.003), with the "reticular" but not with the "spot" DS pattern (p=0.003) and with the "late" pattern of microangiopathy (p=0.001).
The severity of nailfold microangiopathy seems to correlate in SSc patients with both progressive cutaneous microvascular abnormalities and Medsger's severity score, as evaluated by NVC analysis and DS. The assessment of the microvascular damage may be useful not only during the onset of SSc for the early diagnosis, but also to monitor its evolution.
探讨系统性硬化症（SSc）患者甲襞毛细血管镜检查参数与皮肤毛细血管扩张（TA）存在情况之间的相关性。
招募了33例符合美国风湿病学会（ACR）/欧洲抗风湿病联盟（EULAR）标准的SSc患者（28例女性和5例男性，平均年龄59±21岁），其中30例为局限性皮肤型（lcSSc），3例为弥漫性皮肤型（dcSSc），这些患者的面部、手部、前臂、颈部和胸部存在皮肤TA。进行甲襞视频毛细血管镜检查（NVC），将患者分为SSc微血管病变的三种主要模式之一（“早期”、“活动期”、“晚期”），并计算微血管病变演变评分（MES）。SSc患者还接受了皮肤镜检查（DS），以分析TA评分和模式（点状或网状）。研究了临床发现、血清自身抗体、TA模式与NVC模式和MES之间可能的相关性。
发现“晚期”NVC模式与TA总数最多相关（p=0.005）：特别是在“晚期”模式的SSc患者中，“点状”和“网状”TA模式分布相同。发现高MES值与TA总数最多相关（p=0.003），与“网状”而非“点状”DS模式相关（p=0.003），与微血管病变的“晚期”模式相关（p=0.001）。
通过NVC分析和DS评估，SSc患者甲襞微血管病变的严重程度似乎与进行性皮肤微血管异常和梅兹格严重程度评分相关。微血管损伤的评估不仅在SSc发病时有助于早期诊断，而且对监测其进展也可能有用。
