Nailfold Capillaroscopic Changes as a Marker of Interstitial Lung Disease in Systemic Sclerosis
Olympia Rudraa b c d e, Subhasmita Baisyaa b c d e, Subhadeep Mallicka b c d e✉, Gobinda Chatterjeea b c d e
- aDepartment of Dermatology, IPGME&R, Kolkata, West Bengal, India
- bAccepted October 30, 2021
- cReceived June 19, 2021
- dReceived in revised form October 23, 2021
- eThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms
- ✉Corresponding author
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Abstract
Background: Systemic sclerosis (SSc) is an autoimmune connective tissue disorder causing microvascular abnormality leading to Raynaud's phenomenon, skin tightening, and nailfold capillary changes. The patient may have systemic involvement, among them interstitial lung disease (ILD) and pulmonary arterial hypertension are mainly associated with disease-related mortality. Aims: To find out an association between nailfold capillaroscopic changes with ILD severity. Materials and Methods: An institution based cross-sectional study was performed among the patients of SSc above 18 years. Detailed history was taken. Clinical examinations, nailfold capillaroscopy (NFC) with a dermatoscope and high-resolution computed tomography (HRCT) scan of thorax were done. Data were analyzed in MedCalc statistical software version 20. Results: Out of total 43 patients, 74.4% ( n = 32) were female. Mean age was 35.05 ± 7.24 years and mean duration 4.28 ± 2.81 years. Diffuse SSc was found in 88.37% ( n = 38). On NFC, early, active, and late patterns were found in 30.2% ( n = 13), 25.6% ( n = 11), and 44.2% ( n = 19) cases, respectively. On HRCT, early, active, and late ILD were present in 18.6% ( n = 8), 37.2% ( n = 16), and 30.2% ( n = 13) cases, respectively. ILD changes were absent in 14% ( n = 6) though NFC changes were present in them. Respiratory symptoms were absent in 20.93% ( n = 9) patients though all had features of early NFC and among them 9.3% ( n = 4) showed early ILD changes on HRCT. Significant associations were found between NFC changes and ILD severity ( P = 0.0003), NFC changes and respiratory symptoms ( P < 0.0001) and between ILD changes and respiratory symptoms ( P < 0.0001). Discussion: NFC, an inexpensive procedure, can be performed in all patients of SSc to detect development of early ILD even before appearance of respiratory symptoms to prevent further progression.
TL;DRNFC, an inexpensive procedure, can be performed in all patients of SSc to detect development of early interstitial lung disease (ILD) even before appearance of respiratory symptoms to prevent further progression. (Semantic Scholar)