Nail Fold Capillaroscopy Abnormality in Behcet's Disease and Relation to Disease Activity among Egyptian Patients

Abstract

Background: Behcet’s disease is a systemic autoimmune disease. Treatment mainly is immunosuppression. It has no sure diagnostic tests and relies mainly on clinical diagnosis. There are few scores to assess Behcet's disease activity (Behcet's Disease Current Activity Form) BDCAF score. Nailfold Capillaroscopy is a technique to visualize capillaries in nailfold area. It can correlate many diseases with the abnormalities in shape of blood capillaries. Objectives: The aim of the work was to find out Nail Fold Capillaroscopy abnormality in Behcet's Disease and its relation to the disease activity. Patients and Methods: A cross sectional-case control study which was done on 50 Behcet’s patients and 30 healthy controls. We assessed nailfold capillaroscopic changes in Behcet’s patients in comparison to controls and the correlation of BDCAF score with nailfold capillary abnormalities. Results: we found that 70% of Behcet's Disease patients had nailfold capillaroscopy abnormalities , a highly statistically significant changes in the capillaries in the form of capillary dilatation (24%), hemorrhage (54%), tortuosity (64%) in comparison to the control group (P<0.001). However, pattern was not specific as BDCAF Score wasn’t related to the capillary changes. Conclusion: Nailfold capillaroscopy showed nonspecific pattern in 70% Behcet's disease patients. Tortuosity, hemorrhages, dilation were not related to disease activity. Capillaroscopy is a good primary test for Bechet’s disease and can reflect the presence and extent of microvascular involvement and thereby might have diagnostic and prognostic value.