Abstract

Nailfold capillaroscopy (NFC) is a non-invasive technique that allows visualization of the microvascular abnormalities associated with autoimmune connective tissue disorders (ACTDs). This study aimed to evaluate the nailfold capillaroscopic findings in various ACTDs and correlate them with clinical features and disease severity. Methods: This cross-sectional observational study enrolled 50 patients clinically diagnosed with systemic sclerosis (SSc), systemic lupus erythematosus (SLE), mixed connective tissue disease (MCTD), and dermatomyositis. Comprehensive medical histories, clinical examinations, and relevant investigations were performed. Nailfold capillaroscopy was conducted using a hand-held dermoscope, and images were analyzed for capillary morphology, density, and patterns. Statistical analysis compared capillaroscopic findings across disease groups and assessed associations with clinical features. Results: Among the 50 patients, avascular areas (72%), tortuous capillaries (56%), and dilated capillaries (52%) were the most frequent capillaroscopic findings. Avascular areas were most prevalent in SSc (84%), while dilated capillaries were more common in SLE (85%). The scleroderma pattern was observed in 50% of SSc patients and 15% of SLE patients. Significant associations were found between capillaroscopic patterns and clinical features like Raynaud's phenomenon, digital ulceration, proximal muscle weakness, photosensitivity, and respiratory involvement (p < 0.05). Conclusion: Nailfold capillaroscopy aids in the evaluation of microvascular abnormalities in ACTDs, potentially improving diagnostic accuracy and guiding therapeutic decisions. Distinct capillaroscopic patterns were associated with specific clinical manifestations, highlighting the utility of this technique in disease management.

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