Rudra Olympia, Baisya Subhasmita, Mallick Subhadeep, Chatterjee Gobinda
Department of Dermatology, IPGME&R, Kolkata, West Bengal, India.
Indian Dermatol Online J. 2022 Mar 3;13(2):216-220. doi: 10.4103/idoj.idoj_393_21. eCollection 2022 Mar-Apr.
Systemic sclerosis (SSc) is an autoimmune connective tissue disorder causing microvascular abnormality leading to Raynaud's phenomenon, skin tightening, and nailfold capillary changes. The patient may have systemic involvement, among them interstitial lung disease (ILD) and pulmonary arterial hypertension are mainly associated with disease-related mortality.
To find out an association between nailfold capillaroscopic changes with ILD severity.
An institution based cross-sectional study was performed among the patients of SSc above 18 years. Detailed history was taken. Clinical examinations, nailfold capillaroscopy (NFC) with a dermatoscope and high-resolution computed tomography (HRCT) scan of thorax were done. Data were analyzed in MedCalc statistical software version 20.
Out of total 43 patients, 74.4% ( = 32) were female. Mean age was 35.05 ± 7.24 years and mean duration 4.28 ± 2.81 years. Diffuse SSc was found in 88.37% ( = 38). On NFC, early, active, and late patterns were found in 30.2% ( = 13), 25.6% ( = 11), and 44.2% ( = 19) cases, respectively. On HRCT, early, active, and late ILD were present in 18.6% ( = 8), 37.2% ( = 16), and 30.2% ( = 13) cases, respectively. ILD changes were absent in 14% ( = 6) though NFC changes were present in them. Respiratory symptoms were absent in 20.93% ( = 9) patients though all had features of early NFC and among them 9.3% ( = 4) showed early ILD changes on HRCT. Significant associations were found between NFC changes and ILD severity ( = 0.0003), NFC changes and respiratory symptoms ( < 0.0001) and between ILD changes and respiratory symptoms ( < 0.0001).
NFC, an inexpensive procedure, can be performed in all patients of SSc to detect development of early ILD even before appearance of respiratory symptoms to prevent further progression.
系统性硬化症（SSc）是一种自身免疫性结缔组织疾病，可导致微血管异常，进而引发雷诺现象、皮肤紧绷和甲襞毛细血管改变。患者可能出现全身受累，其中间质性肺病（ILD）和肺动脉高压主要与疾病相关死亡率有关。
探究甲襞毛细血管镜检查结果与ILD严重程度之间的关联。
对18岁以上的SSc患者进行了一项基于机构的横断面研究。详细询问了病史。进行了临床检查、使用皮肤镜进行甲襞毛细血管镜检查（NFC）以及胸部高分辨率计算机断层扫描（HRCT）。数据在MedCalc统计软件20版中进行分析。
在总共43例患者中，74.4%（n = 32）为女性。平均年龄为35.05±7.24岁，平均病程为4.28±2.81年。88.37%（n = 38）为弥漫性SSc。在NFC检查中，分别有30.2%（n = 13）、25.6%（n = 11）和44.2%（n = 19）的病例出现早期、活动期和晚期模式。在HRCT检查中，分别有18.6%（n = 8）、37.2%（n = 16）和30.2%（n = 13）的病例出现早期、活动期和晚期ILD。14%（n = 6）的患者虽有NFC改变但无ILD改变。20.93%（n = 9）的患者无呼吸道症状，尽管所有患者都有早期NFC特征，其中9.3%（n = 4）在HRCT上显示有早期ILD改变。NFC改变与ILD严重程度之间（p = 0.0003）、NFC改变与呼吸道症状之间（p < 0.0001）以及ILD改变与呼吸道症状之间（p < 0.0001）均存在显著关联。
NFC是一种成本低廉的检查方法，可用于所有SSc患者，在呼吸道症状出现之前检测早期ILD的发展，以防止病情进一步进展。
