Background Some microvascular abnormalities typical of systemic sclerosis (SSc), that are usually visualized using nailfold videocapillaroscopy (NVC), may appear as skin telangiectases (TAs).
Objectives To assess the progression of the SSc microvascular damage, correlating the microangiopathy evolution score (MES), given by NVC, with dermoscope (DC) profiles of TAs in patients with SSc.
Methods Thirty-three patients (28 women and 5 men, mean age 64 years) affected by limited and diffused SSc (30 and 3 patients respectively), showing the presence of the TAs on face, hands, forearms, neck, décolleté, were enrolled during routinary analysis and after informed consent. All patients were evaluated by NVC (200x magnification, Videocap DS MediGroup,Milan,Italy) to classify and to score the severity of microangiopathy. The appropriate qualitative NCV pattern was assigned to the SSc patients (“early”, “active”, “late”) and the MES was calculated (1,2,3). Three capillaroscopic parameters, namely the loss of capillaries, the disorganisation of the microvascular array and the capillary ramifications, were longitudinally evaluated by the semiquantitative scale (score 0–3 for every parameter) (4). The scores of these parameters were added together, in order to globally assess the variation of the SSc microangiopathy during the time (“microangiopathy evolution score”: score 0–9). The expression of these three nailfold capillary abnormalities was already found increased during the progression of SSc (4,5). DC (25x/40x magnifications, DS MediGroup, Milan, Italy) was employed to examine skin TAs patterns: a “spot” pattern (uniform rounded patch looking-like) and a `'reticular” pattern (network-like) (6).
Results A “late” NVC pattern was associated with a higher total number of TAs (p=0.005) and the “spot” and “reticular” TAs patterns (DC), were found equally associated (p=0.024, in both cases). 82% of patients with the “late” NVC pattern had a MES ≥6 (p=0.001). A MES ≥6 (corresponding to the “late” NVC SSc pattern) was also associated with a higher total number of TAs (p=0.003) and specifically with the “reticular” (p=0.003), but not with the “spot”, DC pattern.
Conclusions NVC of SSc patients evaluated by MES scoring, allows to appreciate the detailed progression of microvascular abnormalities, whereas TAs, that are evaluable by DC, detect specific changes on different skin areas of the body. A significant relationship exists between the MES (score ≥6), the qualitative “late” NVC SSc pattern, and the “reticular” DC pattern.
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Disclosure of Interest None declared