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Nailfold Capillaroscopy and Secondary Raynaud's: Scleroderma

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Low Risk Factors for Systemic Sclerosis
High Risk Factors for Systemic Sclerosis
Raynaud's Secondary to Other Diseases
Research on Capillaroscopy/SSc
Vascular Disease and Scleroderma

Overview

Secondary Raynaud's = Raynaud's due to another illness.
This is also known as Raynaud's Phenomenon.

Nailfold capillaroscopy can determine whether or not Raynaud's is secondary to an illness such as scleroderma. Raynaud's is often the first symptom of scleroderma, and may precede the onset of Scleroderma and other scleroderma symptoms by years or by months.

Only 5% to 20% of people with Raynaud's phenomenon subsequently develop scleroderma, but about 90% of scleroderma patients experience this extreme cold sensitivity with red/blue flashes in their hands and feet as a primary manifestation of their disease. What Causes Raynaud's? National Heart Lung and Blood Institute. NIH.

Low Risk for Developing Systemic Sclerosis

Some people with positive ANA and Raynaud's never go on to develop a defined connective tissue disease (CTD).

A 2006 study presented at the American College of Rheumatology meeting showed that there is a subset of patients with positive ANA and Raynaud's who never go on to develop systemic scleroderma.

High Risk Factors for Systemic Sclerosis

Raynaud's + SSc Antibodies + Abnormal Nailfold = 60x Higher Risk of Systemic Sclerosis

Difficulties in diagnosis of systemic sclerosis-related interstitial lung disease (SSc-ILD). The diagnosis of SSc-ILD could maybe be made sooner if a capillaroscopy was performed earlier, according to the current criteria of early SSc. PMC, Respirol Case Rep, 2015 Sep; 3(3): 99–101. (Also see Pulmonary Fibrosis)

The Prognostic Value of Scleroderma Pattern Capillary Changes and Anticentromere Antibodies for the Development of Very Early Systemic Sclerosis (SSc) - A Follow-up Study of 430 Patients with Raynaud's Phenomenon (RP). Scleroderma pattern of capillary abnormalities found on capillaroscopy was good predictor of future development of SSc, and important test in pts with RP in order to identify those at higher risk of developing SSc. EULAR 2011. Ann Rheum Dis 2011;70(Suppl3):554.

Nailfold Capillaroscopy and Other Diseases

Nailfold Capillaroscopy and Other Diseases. Capillaroscopy can also be useful for the diagnosis of secondary Raynaud's due to diseases other than scleroderma, including glaucoma, graft vs. host disease, rheumatoid arthritis, and vascular diseases.

Overview
Glaucoma
Graft vs. Host Disease (GVHD)
Primary Pulmonary Hypertension
Rheumatoid Arthritis
Vascular Disease

Research on Nailfold Patterns in Systemic Sclerosis

Nailfold capillary abnormalities in erectile dysfunction (ED) of systemic sclerosis (SSc). Neither the presence or absence of abnormal capillaroscopy findings nor the subdivision into early, active and late patterns is associated with coexistent ED in SSc. PubMed,Rheumatology, 2013 Dec 5. (Also see Erectile Dysfunction and Scleroderma)

Nailfold capillaroscopy (NFC) abnormalities as predictors of mortality in patients with systemic sclerosis (SSc). Avascular scores higher than 1.5 at NFC was an independent predictor of death in SSc, suggesting that NFC can be useful for predicting SSc outcome. PubMed, Clin Exp Rheumatol, 2013 Jan 16.

Normal Versus Abnormal Findings in Nailfold Capillaroscopy. The majority of patients with clinically recognizable scleroderma (SSc) show a very characteristic combination of capillary abnormalities (giant capillaries, loss of capillaries in the nailfold, hemorrhages and ramifications), the ''scleroderma-type'' changes, which can easily be assessed through pattern recognition. V. Smith Ghent. EULAR 2011 SP0079. Ann Rheum Dis 2011;70(Suppl3):23.

Vascular Disease and Systemic Sclerosis (SSc, Scleroderma)

Vascular Disease and Systemic Scleroderma. The vascular system is our circulatory system. It consists of all the vessels that carry blood and lymph through the body, to and from organs. Vessels include arteries, veins, and capillaries. Any condition that affects the vascular system, all of in part, is considered a vascular disease. ISN.

Overview
Vascular in Scleroderma
Causes
Types in Scleroderma
In Other CTDs
Biomarkers
Angiogenesis
Hypoxia
VEGF
Personal Stories
Related Information
Go to Raynaud's: Diagnosis
 
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