Capillaroscopic patterns and organic involvement in patients with diagnosis of systemic sclerosis. A retrospective study of the cohort from the José de San Martín Clinics Hospital

Autores: María Milena Pertuz, Gardenia Ortuño Lobo, Graciela Arias Tamara, Gustavo Medina, María José López Meiller

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Introduction: systemic sclerosis (SS) compromises the microvasculature, affecting multiple organs. Nail bed capillaroscopy (NVC) is a non-invasive and easily accessible tool and is considered a marker of vascular damage.

Objectives: to determine capillaroscopic patterns and their association with organ involvement, including skin, lung, gastrointestinal (GI), muscle, joint, and vascular involvement.

Materials and methods: descriptive, retrospective study. Patients over 18 years of age who met the 2013 American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) classification criteria and who had an NVC performed during the consecutive period from December 2018 to December 2020 were included.

Results: a total of 108 patients were included, 104 of whom were women. The capillaroscopic patterns observed were: active SD pattern in 41.6%, late SD in 30.5%, and early SD in 7.4%. The early SD pattern behaved as a protective factor for the development of ischemic lesions. In patients with a late SD pattern, a statistically significant association was found with gastrointestinal involvement, ischemic lesions, and pulmonary hypertension (p=0.03, p=0.01, and p=0.03, respectively).

Conclusions: this study highlights the importance of NVC in the evaluation of patients with systemic sclerosis, as it is a useful tool that provides information for disease staging and prognosis assessment. Prospective studies in Latin America would be valuable, as they could identify potential differences in capillaroscopic findings in this population. These differences may be related to ethnic and geographic factors, supporting the need to generate local evidence.