Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China.
Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
Australas J Dermatol. 2023 Nov;64(4):514-521. doi: 10.1111/ajd.14157. Epub 2023 Sep 18.
Hand-held dermoscopy is a valuable tool for dermatologists, but it has been rarely used to assess the nail fold capillary (NFC) in patients with dermatomyositis (DM).
Patients were collected from the Department of Dermatology and Venereology from July 2020 to July 2021, and the follow-up was conducted until January 2022. Demographic features, disease activity and NFC changes were analysed using a hand-held dermoscopy.
The most common NFC finding in our study was bushy capillary (87.0%). There was no significant improvement in scleroderma-dermatomyositis (SD)-like nail fold changes or enlarged capillaries from baseline to 12 weeks of treatment (p > 0.05) or from 12 weeks to 24 weeks of treatment (p > 0.05), but there was a significant improvement from baseline to 24 weeks of treatment (p < 0.05). The avascular area did not improve from baseline to 12 weeks of follow-up, but the changes were significant from 12 weeks to 24 weeks of treatment (p < 0.05) and baseline to 24 weeks of treatment (p < 0.05). Periungual erythema improved significantly from baseline to 12 weeks of treatment (p < 0.05) and baseline to 24 weeks of treatment (p < 0.05), but it did not improve significantly from 12 weeks to 24 weeks of treatment (p > 0.05). There was no significant difference in disease activity between patients with or without specific NFC changes. However, some NFC features improved as disease activity decreased.
Dermoscopy of NFC is a cost-effective option for the preliminary diagnosis of DM. Further, long-term follow-up is necessary to study the relationship between disease activity and NFC changes.
手持式皮肤镜检查是皮肤科医生的一种有价值的工具，但它很少用于评估皮肌炎（DM）患者的甲襞毛细血管（NFC）。
本研究于 2020 年 7 月至 2021 年 7 月期间从皮肤科和性病科收集患者，并在 2022 年 1 月前进行随访。使用手持式皮肤镜分析患者的人口统计学特征、疾病活动度和 NFC 变化。
在本研究中，最常见的 NFC 表现是丛状毛细血管（87.0%）。从基线到 12 周治疗期（p>0.05）或从 12 周到 24 周治疗期（p>0.05），硬皮病-皮肌炎（SD）样甲襞变化或毛细血管扩张均无显著改善，但从基线到 24 周治疗期有显著改善（p<0.05）。无血管区从基线到 12 周的随访期内没有改善，但从 12 周到 24 周的治疗期（p<0.05）和基线到 24 周的治疗期（p<0.05）有显著变化。甲周红斑从基线到 12 周的治疗期（p<0.05）和基线到 24 周的治疗期（p<0.05）有显著改善，但从 12 周到 24 周的治疗期无显著改善（p>0.05）。有或无特定 NFC 变化的患者之间的疾病活动度无显著差异。然而，随着疾病活动度的降低，一些 NFC 特征有所改善。
NFC 皮肤镜检查是 DM 初步诊断的一种具有成本效益的选择。此外，还需要进行长期随访，以研究疾病活动度与 NFC 变化之间的关系。
