Capillaroscopic changes in patients with Raynaud's phenomenon and occupational diseases

Abstract

Capillaroscopy is a non-invasive method of leading importance for the early diagnosis of progressive systemic sclerosis and other systemic rheumatic diseases with manifestations of Raynaud's phenomenon. Capillaroscopic changes in patients with occupational diseases are still scarce and poorly defined. Of interest is vibration disease, in which small blood vessels are affected with the appearance of "occupationally induced Raynaud's phenomenon". Most studies reported dystonias with observation of spastic capillaries, dilated capillaries, aneurysmal dilations, pericapillary edema, hemorrhages, avascular areas. An important consideration for rheumatology practice is that scleroderma is not observed in these patients - a similar type of microangiopathy characteristic of rheumatic diseases, which in the early stages is defined by the presence of giant capillaries with a diameter of a capillary arm over 50 µm. At present, there is no standardization for the changes in microcirculation that develop as a result of the risk factors of the work environment, which is probably related to the variability of the findings given the different duration and intensity of exposure, as well as to the possible impact of a combination of occupational risk factors.