Nailfold capillaroscopy plays a key role in the assesssment of the patient with Raynaud’s phenomenon, in that it allows early identification of the patient with an underlying systemic sclerosis (SSc)-spectrum disorder [1,2]. This session will review the criteria for primary (idiopathic) Raynaud’s phenomenon, outline the rationale for separating this out from secondary Raynaud’s phenomenon (with a focus on SSc-related Raynaud’s phenomenon) , discuss capillaroscopic abnormalities as a predictor of SSc [4,5], and discuss the recently proposed criteria for very early SSc [6,7] (highlighting capillaroscopy).
Upon completion of the session, participants should be able to:
Discuss the role of capillaroscopy in the assessment of the patient presenting with Raynaud’s phenomenon.
Describe the rationale for very early diagnosis of SSc.
Herrick, A.L. & Cutolo, M. Clinical implications from capillaroscopic analysis in patients with Raynaud’s phenomenon and systemic sclerosis. Arthritis Rheum. 62, 2595-2604 (2010).
Cutolo, M., Sulli, A. & Smith, V. Assessing microvascular changes in systemic sclerosis diagnosis and management. Nat. Rev. Rheumatol. 6, 578-587 (2010).
Herrick, A.L. The pathogenesis, diagnosis and treatment of primary and secondary Raynaud’s phenomenon. Nat. Rev. Rheumatol. 8, 469-79 (2012).
Koenig, M, et al. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud’s phenomenon to systemic sclerosis: a twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum. 58, 3902-3912 (2008).
Ingegnoli, F. et al. Improving outcome prediction of systemic sclerosis from isolated Raynaud’s phenomenon: role of autoantibodies and nail-fold capillaroscopy. Rheumatol. 49, 797-805 (2010).
Matucci-Cerinic, M. et al. The challenge of early systemic sclerosis for the EULAR Scleroderma Trial and Research Group (EUSTAR) community. It is time to cut the Gordian knot and develop a prevention or rescue strategy. Ann. Rheum. Dis. 68, 1377-1380 (2009).
Avouac, J. et al Preliminary criteria for the very early diagnosis of systemic sclerosis: results of a Delphi Consensus Study from EULAR Scleroderma Trials and Research Group. Ann. Rheum. Dis. 70, 476-481 (2011).
Disclosure of Interest None Declared
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