Keywords
occupational diseases
rheumatic diseases
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Abstract
Capillaroscopy is a non-invasive method for assessing microcirculation that provides important information about the condition of capillaries and the pericapillary space. The method is valuable for the diagnosis and monitoring of various diseases with manifestations of Raynaud's phenomenon (RP), such as systemic connective tissue diseases, diabetes, hypertension, occupational diseases and other conditions that lead to microcirculation disorders. It plays an extremely important role in the early diagnosis and prognosis of these diseases, helping to detect both functional and structural changes in the capillary network, even in cases in the absence of many characteristic clinical symptoms.
Raynaud's phenomenon is a disease characterized by reversible attacks of vasospasm leading to impaired peripheral circulation. It can be primary (idiopathic) or secondary (associated with other diseases). Capillaroscopy is the gold standard in rheumatology practice for differentiating primary from secondary Raynaud's phenomenon and has been included in the EULAR/ACR classification criteria for systemic sclerosis (SSc) since 2013. In primary RP, functional disorders of the capillaries are observed, without structural changes, while in secondary RP, which is associated with systemic, general or occupational diseases, it leads to various structural changes with characteristic signs of microangiopathy. The method has not only diagnostic, but also prognostic value in systemic sclerosis, lupus erythematosus, dermatomyositis, etc. Specific capillaroscopic patterns are observed - "scleroderma" and "scleroderma-like", and non-specific changes can also be detected in the early stages of the disease...
References
1. Andracco R, Irace R, Zaccara E et al. The cumulative number of microhaemorrhages and microthromboses in nailfold videocapillaroscopy is a good indicator of disease activity in systemic sclerosis: a validation study of the NEMO score. Arthritis Res Ther. 2017;19(1):133.
2. Boyadzhieva, V, Stoilov, N. Methods for assessment of microcirculation. Revmatologiia (Bulgaria). 2021, 29, 1, 73-84. DOI:https://doi.org/10.35465/29.1.2021.pp73-84.
3. Chen Q, Chen G, Xiao B, et alNailfold capillary morphological characteristics of hand-arm vibration syndrome: a cross-sectional studyBMJ Open 2016;6:e012983. doi: 10.1136/bmjopen-2016-012983
4. Chojnowski MM, Felis-Giemza A, Olesińska M. Capillaroscopy – a role in modern rheumatology. Reumatologia. 2016;54(2):67-72. doi: 10.5114/reum.2016.60215. Epub2016 Jun 3. PMID: 27407282; PMCID: PMC4918046.
5. Cordeiro RA, Andrade RM. Raynaud's phenomenon in the occupational context. Rev Assoc Med Bras (1992). 2019 Nov 7;65(10):1314-1320. doi: 10.1590/1806-9282.65.10.1314. PMID: 31721965.
6. Cutolo M. Paolino S, Smith V. Nailfold capillaroscopy in rheumatology: ready for the daily use but with care in terminology. Clinical Rheumatology 2019;38(9), 2293-2297.
7. Doncheva-Dilova J., Boyadzhieva Vl., Emin S., Stoilov N. Capillaroscopy in antiphopspholipid syndrome. Rheumatology (Bulgaria), 32 (2), 46-59. ISSN 1310-0505 (print).
8. Doncheva-Dilova, J., Boyadzhieva, V., Stoilov, N., & Kuneva, T. (2021). Capillaroscopy as a method for diagnosing microvascular disorders in systematic diseases, Raynaud’s syndrome and vibration disease. Rheumatology (Bulgaria), 29(2), 61-72. https://doi.org/10.35465/29.2.2021.pp61-72
9. Hildegard Rand Maricq, Capillaroscopy in Raynaud's syndrome, Vascular Medicine Review 1992; 3: 3-20
10. Hiroshi KAJI, Wenzeslav BOSSNEV, Hiroki HONMA, Kikujiro SAITO, Takao TSUTSUI and Masato MATSUOKA, CAPILLAROSCOPY OF FINGER NAILFOLD AS A TOOL FOR STUDYING PERIPHERAL CIRCULATION DISORDERS IN HAND-ARM VIBRATION SYNDROME. JJOMT, 52 : 153—160, 2004. Available from: http://www.jsomt.jp/journal/pdf/052030153.pdf
11. Hirschl M, Hirschl K, Lenz M et al. Transition fromprimary Raynaud‘s phenomenon to secondary Raynaud‘s phenomenon identified by diagnosisof an associated disease: results of ten years of prospective surveillance. Arthritis Rheum, 2006;54:1974-81.
12. J. Doncheva-Dilova, N. Stoilov, S. Lambova, V. Boyadzhieva. Capillaroscopic changes in patients with Raynaud’s phenomenon and occupational diseases. Rheumatology (Bulgaria), 32 (1), 72-85. Аvailable from: https://www.rheumatologybg.org/journal/index.php?journal=revmatologiia&page=issue&op=view&path%5B%5D=28&path%5B%5D=28
13. Johnson D, van Eeden C, Moazab N, Redmond D, Phan C, Keeling S, Gniadecki R, Cohen Tervaert JW and Osman M (2021) Nailfold Capillaroscopy Abnormalities Correlate With Disease Activity in Adult Dermatomyositis. Front. Med. 8:708432. doi: 10.3389/fmed.2021.708432
14. Jung P, Trautinger F. Capillaroscopy. J Dtsch Dermatol Ges. 2013 Aug;11(8):731-6. English, German. doi: 10.1111/ddg.12137. Epub 2013 Jun 5. PMID: 23738531.
15. Lambova SN. The Value of Nailfold Capillaroscopy in the Classification and Differential Diagnosis of Raynaud's Phenomenon in Rheumatology. Curr Rheumatol Rev. 2023 Sep 5. doi: 10.2174/1573397119666230905151903. Epub ahead of print. PMID: 37691224.
16. Lambova, Sevdalina & Boyadzhieva, Vladimira. (2021). National consensus for capillaroscopy in rheumatology. Rheumatology (Bulgaria). 29. 10.35465/29.4.2021.pp3-14.
17. Lambova, Sevdalina & Müller-Ladner, Ulf. (2012). Capillaroscopic pattern in systemic lupus erythematosus and undifferentiated connective tissue disease: What we still have to learn?. Rheumatology international. 33. 10.1007/s00296-012-2434-0.
18. Lambova, Sevdalina & Müller-Ladner, Ulf. (2019). Nailfold capillaroscopy in systemic sclerosis – state of the art: The evolving knowledge about capillaroscopic abnormalities in systemic sclerosis. Journal of Scleroderma and Related Disorders. 4. 239719831983348. 10.1177/2397198319833486.
19. Lambova, Sevdalina & Stoilov, Nikolay & Boyadzhieva, Vladimira. (2023). Capillaroscopic findings in undifferentiated connective tissue disease with Raynaud’s phenomenon. Rheumatology (Bulgaria). 31. 44-54. 10.35465/31.3.2023.pp44-58.
20. Lambova, Sevdalina. (2008). The role of capillaroscopy in rheumatology. Revmatologiia. 16. 17-27.
21. Lambova, Sevdalina. (2018). Raynaud’s Phenomenon. 10.5772/intechopen.79362.
22. Lee CB, Sung JH, Park JH, Yoo CI, Sim CS, Oh JS, Lee H. Nailfold capillary microscopy for evaluating hand-arm vibration syndrome. Ann Occup Environ Med. 2014 Oct;26(1):27. https://doi.org/10.1186/s40557-014-0027-y
23. LeRoy E, Medsger JT. Raynaud‘s phenomenon: a proposal for classification. Clin Exp Rheumatol. 1992;10(5):485-8.
24. Littleford RC, Khan F, Hindley MO, Ho M, Belch JJ. Microvascular abnormalities in patients with vibration white finger. QJM. 1997 Aug;90(8):525-9. doi: 10.1093/qjmed/90.8.525. PMID: 9327031.
25. M. VAYSSAIRAT, B. PATRI, J.-F. MATHIEU, M. LIENARD, J. DUBRISAY, E. HOUSSET, Raynaud's phenomenon in chain saw users. Hot and cold finger systolic pressures and nailfold capillary findings, European Heart Journal, Volume 8, Issue 4, April 1987, Pages 417–422, https://doi.org/10.1093/oxfordjournals.eurheartj.a062296
26. Sakaguchi, Shunji & Miyai, Nobuyuki & Takemura, Shigeki & Fukumoto, Jin & Tomura, Taro & Shiozaki, Maki & Kurasawa, Shigeki & Yokoi, Katsushi & Terada, Kazufumi & Yoshimasu, Kouichi & Miyashita, Kazuhisa. (2011). Morphologic Classification of Nailfold Capillary Microscopy in Workers Exposed to Hand-arm Vibration. Industrial health. 49. 614-8. 10.2486/indhealth.MS1200.
27. Sambataro D, Sambataro G, Zaccara E et al. Nailfold videocapillaroscopy micro-haemorrhage and giant capillary counting as an accurate approach for a steady state definition of disease activity in systemic sclerosis. Arthritis Research & Therapy 2014, 16:462
28. Sirufo MM, Bassino EM, Microvascular Damage in a Young Female Archer Assessed by Nailfold Videocapillaroscopy: A Case Report. PMID: 32545690, PMCID: PMC7344696, DOI: 10.3390/ijerph17124218
29. Smith V, Herrick AL, Ingegnoli F, et al. Standardization of nailfold capillaroscopy for the assessment of the patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmunity Reviews 2020;19:1-14.
30. Soubrier C , Seguier J, Di Costanzo M-P et al. Nailfold videocapillaroscopy alterations in dermatomyositis, antisynthetase syndrome, overlap myositis, and immune-mediated necrotizing myopathy. Clin Rheumatol. 2019:1-8.
31. Алексиев T. Методи за оценка на микроциркулацията на кожата при феномен на Рейно. Medical Magazine, 2020.
32. Добрев Х, Вутова Н. Роля на видеокапиляроскопията за ранно диагностициране и мониториране на системна склеродермия. Дерматология, 2015(15).
33. Ж. Дончева – Дилова, В. Миланов. Професионални неоплазми. Медицински преглед, vol. LX, 2024 № 6 (том 60, брой 6, 2024 г.)
34. Кехайов- Болест и синдром на Рейно – разлики, симптоми, изследвания, лечение”, съдова хирургия.
35. Костова В, Петкова В. Професионални болести, второ допълнено и преработено издание – София, 2007 г.
36. Стойнева Зл. Капиляроскопия при феномен на Рейно. Neurosonology and cerebral hemodynamics, 2010; 6(2); 111-115.
37. Стойнева Зл. Микроваскуларни нарушения при вибрационна болест от локално вибровъзействие, Невросонология и мозъчна хемодинамика, 2014; 10(1).
38. Стойнева Зл., Дерменджиев С, Аролски И. Периферносъдови и микроциркулаторни нарушения при вибрационна болест от локално вибровъздействие. Редки болести и лекарства сираци 2017;8(3):9-11.
39. Vayssairat M, Patri B, Guilmot JL et al. La capillaroscopie dans la maladie des vibrations [Capillaroscopy in vibration disease]. Nouv Presse Med. 1982 Oct 23;11(42):3111-5. French.
40. Patri B, Vayssairat M, Guilmot JL et al. Le syndrome de Ray-naud des bûcherons utilisant une scie tronçonneuse. Epidé-miologie, clinique et capillaroscopie [Raynaud‘s syndrome in lumberjacks using chain saws. Epidemiology, clinical and cap-illaroscopic findings]. J Mal Vasc. 1985;10(4):259-63. French.
41. Cutolo M, Smith V. State of the art on nailfold capillaroscopy: a reliable diagnostic tool and putative biomarker in rheuma-tology? Rheumatology 2013;52:19331940; doi:10.1093/rheu-matology/ket153; Advance Access publication 25 April 2013
42. Musculoskeletal Key Fastest Musculoskeletal Insight Engine. Capillaroscopy. Available from: https://musculoskeletalkey.com/capillaroscopy/
43. International Agency for Research on Cancer (IARC). Vinyl chloride, polyvinyl chloride and vinyl chloride-vinyl acetate copolymers. In: IARC monographs on the evaluation of carcinogenic risk of chemicals to humans. Lyon: International Agency for Research on Cancer; 1979. p.377-438.
44. Rodrigues H, Reigota C, Teles C, Moreira S, Santos L. Solvent-Induced Raynaud's Phenomenon. Cureus. 2023 Sep 11;15(9):e45004. doi: 10.7759/cureus.45004. PMID: 37829986; PMCID: PMC10565523.
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Copyright (c) 2025 Jaklin Svetoslavova Doncheva - Dilova, Tanja Kuneva, Daliya Tsvetanova Pencheva, Soner Emin, Vladimira Boyadzhieva, Nikolay Stoilov (Author)