OBJECTIVE: The cold stimulus-fingertip lacticemy test (CS-FTL) evaluates a microcirculation biochemical component and presents abnormal results in systemic sclerosis (SSc). Nailfold capillaroscopy is a well established method for the assessment of morphological aspects of Raynaud's phenomenon associated with SSc. The present study sought to compare the nailfold capillaroscopy findings with the CS-FTL parameters in individual fingers of patients with systemic sclerosis. METHODS: 14 SSc patients with 3 fingers having discrepant degree of microangiopathic SD pattern by nailfold capillaroscopy were studied. Fingertip lacticemy was determined in the three fingers selected before (pre-CS-FTL) and 10 minutes after cold stimulus (post-CS-FTL). The percentage difference between post- and pre-CS-FTL was designated ΔCS-FTL. RESULTS: There was great intraindividual variability (between the different digits) in values of the CS-FTL test. There was no statistically significant difference in pre-CS-FTL, post-CS-FTL and ΔCS-FTL values when comparing the fingers with similar capillaroscopic pattern and the discrepant finger in the 14 SSc patients. There was no correlation between the morphological findings registered by nailfold capillaroscopy and the functional alterations measured by the CS-FTL test. CONCLUSIONS: The absence of correlation between morphological microangiopathic alterations detected by nailfold capillaroscopy and the functional perfusion alterations, verified by the CS-FTL test, suggests a relationship between the latter and proximal vascular lesions, such as arterioles, digital and palmar arch arteries.
systemic sclerosis; Raynaud's disease; nailfold capillaroscopy; microcirculation
