Nailfold capillaroscopy in systemic sclerosis: is there any difference between videocapillaroscopy and dermatoscopy?

BACKGROUND: Vasculopathy is known to destroy nailfold capillary pattern (NCP) in systemic sclerosis (SSc). There are several methods for the evaluation of NCP of which the most common are dermatoscopy and videocapillaroscopy (VCAP). No study has been reported in the literature comparing these two techniques for their diagnostic value.

OBJECTIVE: To compare the diagnostic value of dermatoscopy and VCAP which are widely used to determine changes in the NCP in SSc patients.

METHODS: A total of 382 nailfolds were visualized. NCP was evaluated in 39 SSc patients using dermatoscopy and VCAP. Defined dermatoscopic groups were matched with early, active and late phase NCP groups determined by VCAP for comparisons.

RESULTS: Both dermatoscopy and VCAP demonstrated distinct NCP of SSc efficiently. According to dermatoscopic NCP, capillary dilatation, giant capillaries and disrupted vascular configuration were able to be visualized. VCAP revealed early phase NCP in N = 8 (20,5%), active phase in N = 18 (46,2%) and late phase NCP in N = 13 (33.3%) of the patients. Statistical evaluation of grouped data resulted a Cohen kappa value (K) = 0,527. Although VCAP was able to facilitate a more detailed evaluation of NCP, there was no difference between dermatoscopy and VCAP for the identification of distinct NCP in SSc.

CONCLUSION: We suggest that dermatoscopy is efficient enough to identify pathognomonic changes in NCP in SSc as well as VCAP and find dermatoscopy as a very easy applicable and convenient method than VCAP although VCAP facilitates a more detailed evaluation of NCP.