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  1. E. Ramos1,
  2. A. Guillén-Del-Castillo2,
  3. C. P. Simeón-Aznar2,
  4. B. Gracia Tello3,4,
  5. V. Fonollosa Pla2,
  6. A. Selva-O’callaghan2,
  7. L. Sáez-Comet5,
  8. E. Martínez Robles6,
  9. J. J. Rios6,
  10. G. Espinosa7,
  11. J. A. Todolí Parra8,
  12. J. L. Callejas-Rubio9,
  13. N. Ortego9,
  14. B. Marí-Alfonso10,
  15. M. Freire11,
  16. P. Fanlo12
  1. 1Zaragoza, Computer Science Graduate by University of Zaragoza, Zaragoza, Spain
  2. 2Hospital Universitario Vall d’Hebron, Unit of Autoimmune Diseases, Department of Internal Medicine, Barcelona, Spain
  3. 3Hospital Clinico Universitario Lozano Blesa, Department of Internal Medicine, Zaragoza, Spain
  4. 4Zaragoza, Instituto de Investigación Sanitaria de Aragón (ISSA), Zaragoza, Spain
  5. 5Hospital Universitario Miguel Servet, Department of Internal Medicine, Zaragoza, Spain
  6. 6Hospital General Universitario La Paz, Department of Internal Medicine, Madrid, Spain
  7. 7Hospital Clínic, Department of Internal Medicine, Unit of Autoimmune Diseases, Barcelona, Spain
  8. 8Hospital La Fe, Department of Internal Medicine, Valencia, Spain
  9. 9Hospital Universitario Virgen de las Nieves, Unit of Autoimmune Diseases, Department of Internal Medicine, Granada, Spain
  10. 10Hospital Universitario Parc Taul, Department of Internal Medicine, Sabadell, Spain
  11. 11Complejo Hospitalario Universitario de Santiago, Department of Internal Medicine, Santiago de Compostela, Spain
  12. 12Complejo Hospitalario de Navarra, Department of Internal Medicine, Pamplona, Spain


Background: A nailfold capillaroscopy procedure is a non-invasive, low-cost, and well-established examination that can be used to diagnose several rheumatic autoimmune diseases and support the necessary follow-up of patients. While the clinical implications of the technique are known, a rigorous and in-depth examination of nailfold capillaries remains as one of the major challenges to produce new advances in research and diagnosis, due to practical limitations for analysing the whole nailfold area of each patient. The difference between the different patterns established by Maricq and Cutolo makes it possible to predict the evolution that the patient will present. We introduce, an automatic image reading system able to recognize capillaries in images obtained with any microscope, generate automatic measurements of each capillary and take advantage of this information to report capillary morphology and patterns.

Objectives: to determine the ability to detect active and early scerodermiform patterns of

Methods: Forty-nine complete capillaroscopies, reported by expert capillaroscopists according to the different patterns manually (gold standard), were compared with the pattern detection capability of A scoring system based on the algorithm of the Spanish Capillaroscopy Study Group (GREC) was performed and interpreted by for the global interpretation of each of the capillaroscopies analyzed.

Results: Overall, 37 of the 49 capillaroscopies reported agreed with the diagnosed pattern (75.51%). Separately, the early pattern presented a concordance of 77.27% and the active pattern of 74.07%. In reference to the findings detected by the system, the mean overall density was 5.01 capillaries/mm in the group with the active pattern compared to 6.46 capillaries/mm in the early pattern. The density of dilations and megacapillaries was 2.81/mm and 1.21/mm in the active pattern group versus 4.69/mm and 0.4/mm in the early pattern group. Global diameters were greater in the active pattern group with an apical mean of 37.3 μm compared to 28.5 μm in the early pattern subgroup.

Conclusion: is a simple, easy-to-learn web system for interpreting capillaroscopic images of nail folds. It can be a very useful tool to standardize the interpretation of capillaroscopic images, not only individually for each capillary, but also jointly through the detection of different patterns.

References: [1]Chen K, Wang J, Pang J, Cao Y, Xiong Y, Li X, et al. MMDetection: Open MMLab Detection Toolbox and Benchmark. arXiv preprint arXiv:190607155 2019;.

[2]Cutolo M, Pizzorni C, Sulli A. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis - Reply. The Journal of Rheumatology 2000 11;27:2722–2723.

[3]Cutolo M, Trombetta AC, Melsens K, Pizzorni C, Sulli A, Ruaro B, et al. Automated assessment of absolute nailfold capillary number on videocapillaroscopic images: Proof of principle and validation in systemic sclerosis. Microcirculation 2018 May;25(4):e12447.

[4]Smith V, Vanhaecke A, Herrick AL, Distler O, Guerra MG, Denton CP, et al. Fast track algorithm: How to differentiate a “scleroderma pattern” from a “non-scleroderma pattern”. Autoimmu- nity Reviews 2019 nov;18(11):102394.

[5]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Research International 2015;2015:1–17.

Disclosure of Interests: Eduardo Ramos Shareholder of: Co-founder and shareholder of, Alfredo Guillén-Del-Castillo: None declared, Carmen Pilar Simeón-Aznar: None declared, Borja Gracia Tello Shareholder of: Co-founder and shareholder of, Vicent Fonollosa Pla: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared

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