Background Pernio is a disorder that affects unprotected skin regions of the individuals who are exposed to nonfreezing, damp cold. Various hypotheses such as abnormal vasoconstriction, vasculitis, and hyperviscosity have been proposed as the underlying pathophysiology. Nailfold video capillaroscopy demonstrates organic or functional changes in the microcirculation.
Objectives The purpose of this study was to examine nailfold capillaries by the video capillaroscopy and evaluate the vascular involvement in patients with idiopathic pernio.
Methods 53 patients with idiopathic pernio (male: female 35:18, mean age 25±9 years) who had consulted the rheumatology outpatient clinic between 2008 and 2011, and age- and sex-matched 38 healthy volunteers (male: female 30:8, mean age 24±4 years) were included in the study. 47 of the patients and all the healthy volunteers were evaluated by the nailfold video capillaroscopy. During the examination, architectural derangement, tortuosity, avascular areas and hemorrhages were investigated and capillary and apical capillary diameters were measured.
Results In the patient group, the mean capillary diameter and the mean apical capillary diameters were 56±15μm and 24±7μm, respectively. The mean capillary diameter and the mean apical capillary diameter were 37±8 μm and 15±4μm in the control group, respectively (both p<0.001). Tortuosity was found in 28 of the patients (60%) and 7 of the healthy volunteers (18%) (p<0.001). All of these differences were independent of the disease activity, smoking and the number of episodes. There were no architectural derangements, avascular areas or hemorrhages.
Conclusions In the present study, increased nailfold capillary diameter, increased apical capillary diameter and the presence of tortuosity were found in patients with pernio regardless of the disease activity. These findings suggest organic damage of the microcirculation.
Disclosure of Interest None Declared
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