Nailfold Video-Capillaroscopy in Sarcoidosis: New Perspectives and Challenges
Maria Chianese,
Gianluca Screm,
Paola Confalonieri,
Francesco Salton,
Liliana Trotta,
Beatrice Da Re,
Antonio Romallo,
Alessandra Galantino,
Mario D’Oria,
Michael Hughes,
Giulia Bandini,
Marco Confalonieri,
Elisa Baratella,
Lucrezia Mondini,
Barbara Ruaro
Affiliations
Maria Chianese
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Gianluca Screm
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Paola Confalonieri
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Francesco Salton
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Liliana Trotta
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Beatrice Da Re
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Antonio Romallo
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Alessandra Galantino
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Mario D’Oria
Division of Vascular and Endovascular Surgery, University Hospital of Cattinara, 34149 Trieste, Italy
Michael Hughes
Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
Giulia Bandini
Department of Experimental and Clinical Medicine, Division of Internal Medicine, Azienda Ospedaliero Universitaria Careggi and University of Florence, 50134 Florence, Italy
Marco Confalonieri
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Elisa Baratella
Radiology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, 34149 Trieste, Italy
Lucrezia Mondini
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Barbara Ruaro
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
Introduction: Nailfold video-capillaroscopy (NVC) is a non-invasive cost-effective technique involving the microscopic examination of small blood vessels of the distal nailfold with a magnification device. It provides valuable information regarding the microcirculation including anomalies such as tortuous or dilated capillaries, hemorrhages, and avascular areas, which can characterize connective tissue diseases. The utility of NVC in the diagnosis and monitoring of systemic sclerosis (SSc) has been investigated in numerous studies allowing the distinction of the specific microvascular pattern of scleroderma from different conditions other than scleroderma (non-scleroderma pattern). Sarcoidosis (SA) is a systemic inflammatory disease that can affect various organs, including the lungs, skin, and lymph nodes. The purpose of our review was to evaluate the current state of the art in the use of NVC in the diagnosis of SA, to understand the indications for its use and any consequent advantages in the management of the disease in different settings in terms of benefits for patients. Materials and Methods: We searched for the key terms “sarcoidosis” and “video-capillaroscopy” in a computerized search of Pub-Med, extending the search back in time without setting limits. We provided a critical overview of the literature, based on a precise evaluation. After our analysis, we examined the six yielded works looking for answers to our questions. Results: Few studies have evaluated that microcirculation is often compromised in SA, with alterations in blood flow and consequent tissue damage. Discussion: Basing on highlighted findings, NVC appears to be a useful tool in the initial evaluation of sarcoidosis patients. Furthermore, capillaroscopy is useful in the evaluation of the coexistence of sarcoidosis and scleroderma spectrum disorder or overlap syndromes. Conclusions: In conclusions, no specific pattern has been described for sarcoidosis, and further re-search is needed to fully understand the implications of nailfold capillaroscopy find-ings in this disease and to establish standardized guidelines for its use in clinical practice.
