Medicina clinica · 2026
Value of nailfold capillaroscopy in the classification of the systemic sclerosis pattern.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Guillén Del Castillo Alfredo, Lledó-Ibáñez Gema M, Sáez Comet Luis, Freire Dapena Mayka, Mesa Navas Miguel, Martín Cascón Miguel, Simeon Carmen Pilar, Martinez Robles Elena, Todolí Parra José, Varela Diana Cristina, Udaondo Gascon Clara, Maldonado Génesis, Mosquera Angarita Juan Manuel, Marín Adela, Pérez Abad Laura, Ramos Ibáñez Eduardo, Gracia Tello Borja Del Carmelo
Аннотация
OBJECTIVES: Nailfold videocapillaroscopy (NVC) is the gold-standard to identify scleroderma patterns. Our aim was to establish the minimum requirements; number of fingers, length of nailbed samples, location of nailbed areas, to diagnose the existence of systemic sclerosis patterns (SSc-P) and further identify non-SSc-P and SSc-P subtypes reliably.
METHODS: NVCs were taken during routine explorations by capillaroscopists from 12 hospitals, who made four diagnosis per patient according to the examination of the following: 32 images (4 images/finger, mean 59.43mm); 16 images (2 medial images/finger [mean 29.28mm]); 8 images (1 medial image/finger [mean 14.50mm]); 4 images (1 medial image per middle fingers [mean 7.22mm]). Diagnosis matches and discrepancies considering 32 versus 16, 8 or 4 images, were calculated, with the goal of estimating the information loss when not covering the whole nailbed. The same analysis was performed using the CAPI-Score and CAPI-Detect algorithms.
RESULTS: A total of 2,387 NVCs were used. Disagreement in pattern assignment was 26.7%, 36.6% and 41.5% when the analysis was performed over 16, 8 or 4 images, respectively. When 16 images were used, 18.5% of expert observers changed their assigned pattern in 18.5% of cases from SSc-P to non-SSc-P, and >30% of patients diagnosed were assigned a different subtype. Although to a lesser extent, diagnosis discrepancies were observed when CAPI-Score and CAPI-Detect algorithms were applied.
CONCLUSION: All fingers but thumbs have to be considered to identify scleroderma patterns accurately. Four nailbed areas in the analysis demonstrated to be superior than using a partial sample.
METHODS: NVCs were taken during routine explorations by capillaroscopists from 12 hospitals, who made four diagnosis per patient according to the examination of the following: 32 images (4 images/finger, mean 59.43mm); 16 images (2 medial images/finger [mean 29.28mm]); 8 images (1 medial image/finger [mean 14.50mm]); 4 images (1 medial image per middle fingers [mean 7.22mm]). Diagnosis matches and discrepancies considering 32 versus 16, 8 or 4 images, were calculated, with the goal of estimating the information loss when not covering the whole nailbed. The same analysis was performed using the CAPI-Score and CAPI-Detect algorithms.
RESULTS: A total of 2,387 NVCs were used. Disagreement in pattern assignment was 26.7%, 36.6% and 41.5% when the analysis was performed over 16, 8 or 4 images, respectively. When 16 images were used, 18.5% of expert observers changed their assigned pattern in 18.5% of cases from SSc-P to non-SSc-P, and >30% of patients diagnosed were assigned a different subtype. Although to a lesser extent, diagnosis discrepancies were observed when CAPI-Score and CAPI-Detect algorithms were applied.
CONCLUSION: All fingers but thumbs have to be considered to identify scleroderma patterns accurately. Four nailbed areas in the analysis demonstrated to be superior than using a partial sample.