Background/Purpose: Nailfold videocapillaroscopy (NVC) is a non invasive and useful method to assess peripheral microvascular status and evaluate patients with connective tissue diseases (1). Microvascular involvement was clearly described in systemic sclerosis (SSc) (2-4), but may be detected also in patients with dermatomyositis (DM) (5,6). Only few studies described the main NVC changes over time in this last clinical condition (5,6). The aim of this retrospective study was to compare the NVC findings between DM and SSc at first NVC, and to identify NVC changes in patients with DM during a 3 year follow-up.

Methods: Twenty-four DM (mean age 54±15SD years; disease duration 4±5 years; 4 males and 20 females) and 24 SSc patients, matched for age and disease duration at first NVC were retrospectively evaluated. NVC was yearly performed by the same operator, and capillary parameters scored as reported in the literature (2-4). Clinical aspects and treatments were recorded. Non parametric test were used to carry out statistical analysis.

Results: Nineteen out of 24 DM patients (79%) showed a NVC “scleroderma-like pattern”. Comparing at baseline DM with SSc patients, the giant capillary and microhaemorrhage scores were significantly higher in SSc than in DM patients (1.42±0.58 vs 1.00±0.72, p=0.04, and 1.00±0.66 vs 0.67±0.56, p=0.05 respectively), while capillary density, ramification (abnormally shaped capillaries, expression of angiogenesis) and disorganization scores were higher in DM patients (1.54±0.72 vs 1.12±0.85, p=0.05; 1.79±1.02 vs 0.79±1.02, p=0.002; 1.67±0.82 vs 0.83±1.01, p=0.004, respectively). Accordingly, the absolute number of ramified capillaries was significantly higher in DM patients (1.92±1.06 vs 0.88±1.08, p=0.002), while the absolute capillary number was significantly higher in SSc patients (6.83±2.18 vs 5.62±1.95, p=0.05) at baseline. No statistically significant variations of all the capillaroscopic scores was observed during the 3 year follow-up in DM patients. By comparing DM patients with or without anti-Jo-1 antibody positivity, no statistically significant differences of the scores of the main capillary parameters was observed at baseline between the groups. However, anti-Jo-1 positive patients showed a statistically significant decrease of capillary ramifications at T2 (score 1.4±1.1 vs 2.6±0.7, p=0.05) and T3 (1.0±0.0 vs 2.6±0.5, p=0.03), when compared with the anti-Jo-1 negative group.

Conclusion: This study demonstrates that DM and SSc display different capillaroscopic features. The capillaroscopic manifestations of DM persist in contrast to the progressive changes described in SSc patients (4), and the anti-Jo-1 positivity do not seem to modify the DM NVC pattern.

References. 1.Cutolo M. et al. Best Pract Res Clin Rheumatol 2007;21:1093-108. 2.Cutolo M et al. Rheumatology 2004;43:719–26. 3.Sulli A et al. Ann Rheum Dis 2008;67:885-7. 4.Sulli A et al. Arthritis Rheum. 2012;64:821-5. 5.Bertolazzi C, et al. Semin Arthritis Rheum. 2017;47:432-444. 6.Manfredi A, et al. J Rheumatol. 2016;43:1575-80.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/nailfold-microangiopathy-in-dermatomyositis-and-systemic-sclerosis-what-is-different/