Association of Dermoscopic Profiles of Telangiectases with Nailfold Videocapillaroscopic Patterns in Patients with Systemic Sclerosis

Abstract

To the Editor: The etiology of systemic sclerosis (SSc) remains elusive, but microangiopathy is considered to be significantly associated with disease pathophysiology1. Morphological microvascular studies in patients with SSc use nailfold videocapillaroscopy (NVC) to examine the papillary capillaries in the nail bed, which run with their major axis parallel to the skin surface2 (Figure 1a). Cutaneous telangiectases (TA) are small enlarged end vessels, mainly permanent dilatation of postcapillary venules of the subpapillary plexus3. They are readily visible; nevertheless, few studies have focused on cutaneous TA4. Figure 1. Dermoscopic spot (a) and reticular (b) telangiectases (TA) patterns are detected by using dermoscopy (DC). Nailfold papillary capillaries run parallel to the skin surface (c); in systemic sclerosis (SSc) their profile is altered and nailfold videocapillaroscopy (NVC) detects scleroderma pattern as early (d), active (e), and late (f) (200× magnification). In the other sites of the body (face, hands, chest), microvascular abnormalities may be revealed as TA (40× magnification; DB-Dermo Mips Leica AG). Dermoscopy (DC) is a noninvasive technique used in the early diagnosis of melanoma5 and nonmelanoma skin cancers, as well as inflammatory skin disorders (psoriasis, lichen … Address correspondence to Dr. M. Cutolo, Research Laboratories and U.O.C. Clinical Rheumatology, Department of Internal Medicine, IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy. E-mail: m.cutolo{at}unige.it