Nailfold Capillaroscopic Changes in Dermatomyositis and Polymyositis Egyptian Patients: Relation to Disease Activity

Abstract

Background: Nailfold capillaroscopy (NFC) has been described to be a valuable instrument used in diagnosis of systemic sclerosis (SSc) and juvenile dermatomyositis (JDM) patients. Though, NFC has been infrequently assessed in adult dermatomyositis (DM) patients. Objectives: Our aim was to visualize nailfold capillary changes in dermatomyositis (DM) and polymyositis (PM) Egyptian patients and to identify a specific diagnostic capillary pattern and to assess its relevance to disease activity, clinical and laboratory findings. Patients and Methods: This study included 20 patients (12 DM, 5 PM, and 3 overlap syndrome). Routine laboratory assessment was done, disease and skin activity scores were evaluated. Assessment of the nailfold capillary circulation using the videocapillaroscope was done and capillary density score was assessed. Results: The mean age was 39±12 years and their mean disease duration was 24±19 months. The mean muscle disease activity score was 3.8±3.3, and global disease activity score (DAS) 3.92±3.09. The mean skin activity score was 2±3. The global DAS was significantly higher in patients with branched capillaries (p=0.041). Skin activity score was significantly higher in patients with capillary hemorrhage (p=0.024). More severe capillaroscopic findings were prominent in DM patients rather than PM or overlap patients. Conclusion: Capillary branching is more common in patients with higher global DAS and capillary hemorrhage is more frequent in patients with higher skin activity score. Capillaroscopic changes are evident in DM patients rather than PM or overlap patients.