Nailfold capillaroscopy plays a particularly important role in the early diagnosis of systemic sclerosis, an autoimmune multisystem disease, since disorders of capillary architecture can often precede other signs of the disease, even by years. It is also a helpful method to classify other diseases from the group of connective tissue diseases. For example, suggestive images can also be found in patients with mixed connective tissue disease or with dermatomyositis.
Nailfold capillaroscopy can also be used to assess the severity of the circulatory disorder in patients with systemic sclerosis, by evaluating the number of capillaries and thus estimating the risk for the occurrence of finger ulcers and other complications.
How is the examination performed?
The method is completely painless and non-invasive. The smallest blood vessels (capillaries) are located on the nail bed just below the surface and, in order to make them more visible, the skin is wetted with highly pure oil.
Using modern videocapillaroscopy, we examine the blood flow and structure of the capillaries and count, measure and assess them according to their shape.
In which diseases should nailfold capillaroscopy be performed?
A typical indication for a nailfold capillaroscopy is the clarification of a Raynaud’s syndrome (whitening, blueness, reddening of the fingers on exposure to cold or nervousness). This is very often harmless and purely functional (primary Raynaud’s phenomenon), but can sometimes be the first sign of a connective tissue disease, in which case it is called secondary Raynaud’s phenomenon.
Patients for whom no further investigations are desired may be referred specifically for nailfold capillaroscopy.
Since 2021, nailfold capillaroscopy can be performed both at the Clinic for Rheumatology and at the Wollishofen Imaging Department of the Institute for Diagnostic and Interventional Radiology USZ. The diagnosis is performed centrally by the Clinic for Rheumatology USZ.