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Abstract This study aimed to evaluate nailfold capillary abnormalities in patients with connective tissue diseases (CTDs) using a videodermatoscope and compare the findings with healthy controls. Seventy-two patients diagnosed with CTDs, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), primary Sjögren’s syndrome (SS), undifferentiated connective tissue disease (UCTD), and thirty-three healthy controls, were included. Capillary abnormalities such as enlarged capillaries, avascular areas, tortuous-twisted capillaries, ramified-bushy capillaries, and hemorrhages were assessed at magnifications of ×20, ×30, and ×40. The scleroderma pattern (SScP) was defined by the presence of two or more abnormalities in at least two nailfolds, with a revised SScP excluding tortuous-twisted capillaries. The standard SScP exhibited a sensitivity of 78.57% and a specificity of 96.97%. SScP was observed in 25% of rheumatoid arthritis (RA) cases, 42.9% of primary Sjögren's syndrome (SS) cases, and 57.1% of undifferentiated connective tissue disease (UCTD) cases, but none in primary RP or systemic lupus erythematosus (SLE) cases. The revised SScP showed a sensitivity of 64.29% and a specificity of 100%. It was found in 28.6% of primary SS cases and 42.9% of UCTD cases, but none in primary RP, SLE, or RA cases. One (3%) of healthy controls exhibited SScP, but none showed the revised SScP. There was no statistically significant difference in detecting tortuous-twisted capillaries between patients and healthy controls (p > 0.05). However, there was a significant difference in identifying the other four parameters (p 0.05), but a significant difference between ×20 and ×40 in detecting tortuous-twisted capillaries (p < 0.05). No significant correlation was found between disease duration and capillaroscopic abnormalities. Videodermatoscopy is a reliable tool for evaluating nailfold capillaries in connective tissue disease (CTD) patients, with magnifications of ×30 and above providing the most detailed assessments. It effectively differentiates primary and secondary Raynaud's phenomenon and highlights the diagnostic value of capillaroscopy in identifying CTD-specific abnormalities, particularly in systemic sclerosis (SSc).
Doğdu et al. (Tue,) studied this question.