OBJECTIVE: Retrospective serial analysis of nailfold capillaroscopy (NFC) alterations and its correlation with diagnostic evolution in patients initially presenting isolated Raynaud's phenomenon (RP) or undifferentiated connective tissue disease (UCTD). METHODS: We evaluated 19 patients with previous diagnosis of isolated Raynaud's Phenomenon or UCTD who had two or more NFC exams within at least one-year interval. RESULTS: Eleven patients have had initial diagnosis of isolated RP; seven maintained the RP diagnosis, three developed Systemic Sclerosis (SSc), and one evolved to Sjögren´s Syndrome (SSj). Eight patients were diagnosed with UCTD in the first evaluation and all of them kept the initial diagnosis. Nine patients presented changes in NFC pattern. Seven patients presented intensification of SD pattern (group A). In three of these patients, the diagnosis has evolved from isolated FRy to SSc. The remaining four cases (one RP and three UCTD) maintained the initial diagnosis. Group B included two cases in which the SD pattern has been attenuated or disappeared. One of these patients has evolved from isolated RP to SSj. Ten patients had the NFC pattern unaltered (Group C) and all of them have kept the initial diagnosis (four with UCTD and six with RP). All patients who had evolved to SSc have shown intensification or appearance of SD pattern (sensitivity=100%). On the other hand, among the 16 patients who have not evolved to SSc, 12 had not shown appearance or intensification of SD pattern (specificity=75%). CONCLUSIONS: The appearance or intensification of SD pattern in serial NFC analysis during the study period has shown high sensitivity and moderate specificity in regard to the development of SSc.
nailfold capillaroscopy; microcirculation; systemic sclerosis; Raynaud's phenomenon
