Samsun Education and Research Hospital, Department of Dermatology, Samsun, Turkey.
Samsun Gazi Government Hospital, Department of Infectious Diseases, Samsun, Turkey.
Microvasc Res. 2020 May;129:103970. doi: 10.1016/j.mvr.2019.103970. Epub 2019 Dec 28.
Nailfold capillaroscopy is a highly sensitive, inexpensive, simple, safe, and noninvasive technique used in the investigation of the microcirculation. However, the diseases having a vasculitic component can cause changes in the nailfold capillaries like viral hepatitis, the microvascular characteristics of the nailfold area in HBV and HCV infected individuals have not been systematically investigated. In this study, we investigated possible dermoscopic differences in the vascular appearance of the nailfold capillaries and their association with the disease's clinical status.
A hundred and forty-seven patients and 147 healthy controls were enrolled in this study. The patients' group consisted of chronic viral hepatitis B (CHB: 54 cases), chronic hepatitis C (CHC: 36 cases) and carrier of hepatitis B virus infection (CRHB: 57 cases). Nailfold capillaroscopy was performed using a digital dermoscope (Molemax II, X30). All capillaroscopy images were evaluated for capillary density, capillary loop enlargement, capillary tortuosities, branching vessels, micro hemorrhages, avascular areas and splinter hemorrhages, and routine laboratory examinations of all patients were performed.
Statistical differences in all of the categories of capillary morphology were prominent between the capillary abnormalities of Hepatitis B and the control group, also the capillary abnormality was significant between hepatitis C and the control group (p < 0.01). None of the 147 healthy control had any nailfold capillary changes. There was a significant difference between the CHB-Control and CRHB-Control groups in all of the capillaroscopic changes (p < 0.01). The avascular area was also the most common finding in Hepatitis C and Hepatitis B infected individuals, and capillary dilatation (CD), capillary tortuosity (CT) and capillary enlargement (CE) were the major nailfold capillary changes in both of two diseases.
Nailfold capillary abnormalities are one of the extrahepatic dermatologic finding which could be a sign of the endothelial tissue damage in chronic viral hepatitis, we do not have any data about the effects of these two usual infections on the nailfold capillary morphology. This is the first study evaluating the microvasculature abnormalities of the nailfold capillaries in hepatitis B and hepatitis C infected individuals by capillaroscopic examination.
甲襞毛细血管显微镜检查是一种高度敏感、廉价、简单、安全和非侵入性的技术，用于研究微循环。然而，具有血管炎成分的疾病会导致甲襞毛细血管发生变化，如病毒性肝炎，HBV 和 HCV 感染个体甲襞区域的微血管特征尚未得到系统研究。在这项研究中，我们研究了甲襞毛细血管血管外观的可能差异及其与疾病临床状态的关系。
本研究纳入了 147 例患者和 147 例健康对照者。患者组包括慢性乙型病毒性肝炎（CHB：54 例）、慢性丙型病毒性肝炎（CHC：36 例）和乙型肝炎病毒携带者（CRHB：57 例）。使用数字皮肤镜（Molemax II，X30）进行甲襞毛细血管镜检查。所有毛细血管图像均评估毛细血管密度、毛细血管环扩大、毛细血管迂曲、分支血管、微出血、无血管区和裂片出血，并对所有患者进行常规实验室检查。
乙型肝炎和对照组之间的所有毛细血管形态类别的统计学差异显著，丙型肝炎和对照组之间的毛细血管异常也显著（p<0.01）。147 例健康对照者均无甲襞毛细血管变化。CHB-对照组和 CRHB-对照组之间所有毛细血管镜变化均有显著差异（p<0.01）。无血管区也是丙型肝炎和乙型肝炎感染个体中最常见的发现，并且毛细血管扩张（CD）、毛细血管迂曲（CT）和毛细血管扩大（CE）是两种疾病中甲襞毛细血管的主要变化。
甲襞毛细血管异常是慢性病毒性肝炎的肝外皮肤表现之一，可能是内皮组织损伤的标志，我们没有关于这两种常见感染对甲襞毛细血管形态影响的数据。这是第一项通过毛细血管镜检查评估乙型肝炎和丙型肝炎感染个体甲襞毛细血管微血管异常的研究。
