Comparative analysis of currently used classifications of capillaroscopic findings in systemic sclerosis patients

Background : Capillaroscopic findings in systemic sclerosis (SSc) are called “scleroderma pattern capillary abnormalities”.

Aim : To make comparative analysis of the currently used classifications of capillaroscopic findings according Maricq and Cutolo and to correlate capillaroscopic findings with demographic, clinical and immunological features of SSc patients.

Material and methods : 44 patients with systemic sclerosis were investigated. All patients were studied by means of nail fold capillary microscopy, interview, physical examination (including age, clinical pattern, duration of Raynaud’s phenomenon and systemic sclerosis, fingers’ sores, pulmonary hypertension and fibrosis), inflammatory and immunological tests. The control group comprised 19 healthy persons.

Results : No significant correlation was found between capillaroscopic findings and demographical, clinical and immunological features of recruited patients, except for a more frequent appearance of dSSc in patients with the “late” capillaroscopy pattern by Cutolo and the “active” pattern by Maricq, and lSSc in patients with the “slow” pattern by Maricq. It has also been shown that the “late” pattern by Cutolo significantly corresponded with the “active” pattern by Maricq and the “active” pattern by Cutolo corresponded with the “slow” pattern by Maricq. We observed a more statistically higher value of sE-selectin in SSc patients than in healthy persons.

Conclusions : Our data indicate that classification of capillaroscopic findings are related to the skin involvement. The “late” pattern by Cutolo and the “active” pattern by Maricq, found in early dSSc, could be associated with an advanced degree of capillaroscopic findings rather than with duration of the disease. The diagnostic value of both capillaroscopic classifications seems to be comparable. The individual capillaroscopic patterns overlapped. The value of sE-selectin seems to be a marker of activity of endothelium, but it does not correlate with severity of SSc.