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Erschienen in: Wiener Medizinische Wochenschrift 9-10/2018

01.02.2018 | case report

Mosaic capillaroscopic findings in systemic sclerosis

verfasst von: Sevdalina Nikolova Lambova, Ulf Müller-Ladner

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 9-10/2018

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Summary

A 67-year-old woman with triphasic Raynaud’s phenomenon since 2 years was diagnosed as having limited cutaneous systemic sclerosis (SSc) 1 year ago based on puffy fingers, positive antinuclear and anti-Scl-70 autoantibodies, and initial pulmonary fibrosis. Capillaroscopic examination revealed “mosaic” capillaroscopic findings that included normal pattern; “scleroderma”-type capillaroscopic pattern “early” phase, with single giant capillaries and haemorrhages, preserved capillary distribution; and “scleroderma”-type capillaroscopic pattern “active” phase, with high number of giant capillary loops and haemorrhages, moderately disturbed distribution. Nailfold capillaroscopy is an established non-invasive imaging technique for morphologic evaluation of the capillaries in the nail-fold area that reveals diagnostic changes in the majority of SSc patients. It has been included in the recently published EULAR/ACR (European League Against Rheumatism/American College of Rheumatology) classification criteria for SSc (2013). The generalized microangiopathy is a cardinal feature of SSc, but the underlying endothelial damage of the capillaries varies in the different compartments of the body, sometimes even within the same organ. As typical capillaroscopic findings are diagnostic in clinical context, this case of a “mosaic” pattern should remind the clinicians that the capillaroscopic examination should be performed for the eight fingers bilaterally (excluding the thumbs because of poor visibility), in order to detect the presence of all types and grades of pathological microvascular changes to facilitate the highest diagnostic accuracy.

Literatur
  1. van den Hoogen F, Khanna D, Fransen J, et al. Classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum. 2013;65(11):2737–47.View ArticlePubMedPubMed Central
  2. van den Hoogen F, Khanna D, Fransen J, et al. Classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2013;72(11):1747–55.View ArticlePubMed
Metadaten
Titel
Mosaic capillaroscopic findings in systemic sclerosis
verfasst von
Sevdalina Nikolova Lambova
Ulf Müller-Ladner
Publikationsdatum
01.02.2018
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 9-10/2018
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-018-0617-3

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