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Systemic sclerosis (SSc) and mixed connective tissue disease (MCTD) are both associated with microvascular pathology. The most striking early clinical manifestation is Raynaud phenomenon (RP), which is only partly caused by functional narrowing of small vessels. Moreover, alteration of endothelial function1 and impairment of endothelial progenitor cell function in these patients have been previously described.2 This may have an important impact on capillary pathology. The resulting morphological changes can be observed by nailfold capillaroscopy (NFC). Haemorrhages, giant capillaries and avascular regions are typical findings that cannot only be detected by NFC, but also, at least in part, with moderate to substantial reliability using simpler methods such as ophthalmoscopes or dermatoscopes.3 These findings …
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