How do the nailfold capillary abnormalities change as Systemic Sclerosis progresses?
There are three patterns of microvascular changes seen on nailfold capillaroscopy (NFC) as patients with SSc progress. Monitoring of NFC helps to identify disease progression as loss of capillary density is correlated with the development of PAH and digital ulcers:
• Early pattern: few giant capillaries, few capillary microhemorrhages, no loss of capillaries, and preserved capillary distribution.
• Active pattern: frequent giant capillaries, frequent capillary microhemorrhages, moderate loss of capillaries, and mild disorganization of capillary architecture.
• Late pattern: giant capillaries and microhemorrhages are nearly absent, severe loss of capillaries, capillary ramification due to neoangiogenesis and disorganized capillaries.
