Value of nailfold capillaroscopy in the classification of the systemic sclerosis pattern;

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Guillén del Castillo A.
  • Lledó-Ibáñez G.M.
  • Sáez Comet L.
  • Freire Dapena M.
  • Mesa Navas M.
  • Martín Cascón M.
  • Simeon C.P.
  • Martinez Robles E.
  • Varela D.C.
  • Udaondo Gascon C.
  • Maldonado G.
  • Mosquera Angarita J.M.
  • Marín A.
  • Pérez Abad L.
  • Ramos Ibáñez E.
  • Gracia Tello B.D.C.

Grupos

Abstract

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. © 2026 Elsevier España, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Datos de la publicación

ISSN/ISSNe:
0025-7753, 1578-8989

MEDICINA CLINICA  ELSEVIER ESPANA SLU

Tipo:
Article
Páginas:
-
PubMed:
42013567
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,325 SCImago
Cuartil:
Q3 SCImago

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Keywords

  • Nailbed areas; Nailbed images; Nailfold videocapillaroscopy; Reliable diagnosis; Scleroderma patterns

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