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SAT0298 Nailfold Capillaroscopic Alterations in Dermatomyositis and Polymyositis
  1. A. Manfredi1,
  2. M. Sebastiani1,
  3. G. Cassone1,
  4. N. Pipitone2,
  5. D. Giuggioli1,
  6. M. Colaci1,
  7. C. Salvarani2,
  8. C. Ferri1
  1. 1University of Modena and Reggio Emilia, Modena
  2. 2Arcispedale Santa Maria Nuova, Reggio Emilia, Italy


Background Inflammatory myopathies (IM) are a group of acquired muscle diseases with heterogeneous features occurring both in children and adults. Nailfold capillaroscopy (NVC) alterations are described in IM, but their frequency, typical features and possible correlation with clinical and serological data are not well defined, including the differences between in polymyositis (PM) and dermatomyositis (DM)

Objectives The aim of this study was to describe the frequency and characteristics of capillaroscopic changes in patients with PM or DM and to look for a possible correlation with clinical and serological features

Methods We analyzed fifty-three unselected, consecutive patients affected by IM in a cross-sectional study over a period of 6 months. NVC findings of 29 DM and 24 PM patients were compared with those of 53 patients with primary Raynaud's phenomenon, matched by age and gender, from the same geographic area. Tortuosities, enlarged and giant capillaries, micro-haemorrhages, ramified capillaries were scored by a semi-quantitative rating scale (0=no changes, 1 = less than 33% of capillary alterations/reduction, 2 = 33–66% of capillary alterations/reduction, 3 = more than 66% of capillary alterations/reduction, per linear millimeter); disorganization of the vascular array, avascular areas and scleroderma pattern were scored as presence/absence. Capillary loss was scored as 0 (≥7 capillaries/mm), 1 (4-6 capillaries/mm), or 2 (≤3 capillaries/mm)

Results PM and DM patients were similar with regard to sex, mean age and mean disease duration. Major capillaroscopic alterations, namely disorganization of the vascular array, enlarged and giant capillaries, capillary loss, and scleroderma-like pattern were observed in IM patients, not in controls. Significant differences were observed between PM and DM with higher frequency and mean score of NVC changes in DM patients (see table) Capillary loss and giant capillaries were more frequent in patients with diagnosis of DM ≤6 months (p not significant)

Conclusions Consistently with the different pathogenesis of DM and PM, our study suggests that capillaroscopic alterations are clearly identified only in DM patients as expression of diffuse microangiopathy mainly capillary loss, enlarged and ramified capillaries; surprisingly more severe changes were associated to shorter disease duration, while persistence of ramified capillaries with long-standing disease

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4305

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