Distinct capillaroscopic findings in a patient with systemic sclerosis: Possible association with a benign disease course

Abstract

Background

Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular abnormalities and fibrosis. Capillaroscopy is a key tool for assessing microvascular changes in SSc, often revealing characteristic patterns with prognostic significance. While the presence of a “scleroderma pattern” is well-documented, its localization to a single digit without systemic involvement is an unusual finding.

Aim of the work

This report highlights a unique capillaroscopic presentation in a patient with anti-centromere antibody-positive SSc, emphasizing its potential prognostic significance.

Case report

A 66-year-old Caucasian female was diagnosed with anti-centromere antibody-positive SSc six years ago. The diagnosis was supported by ANA positivity (1:1280, centromeric pattern), Raynaud’s phenomenon, and transient hand edema. Capillaroscopic examination revealed a “scleroderma pattern” with prominent megacapillaries exclusively on the second finger of the right hand, with no microhemorrhages. The remaining fingers showed a non-specific capillaroscopic pattern. Clinically, the patient has a benign disease course, with no skin sclerosis, digital ulcers, or systemic involvement.

Conclusion

This case highlights the relevance of localized capillaroscopic abnormalities in SSc. The absence of systemic involvement despite the capillaroscopic findings raises questions about their prognostic significance. Further research is needed to clarify their implications.