Nail fold capillary patterns in patients with systemic sclerosis using a hand-held dermoscope – A prospective study from a tertiary center in South India

Introduction: Nail fold dermoscopy is a noninvasive technique which aids in the diagnosis of systemic sclerosis. It also helps in predicting the extent and stage of microvascular damage. There are only a few studies describing the pattern of nail fold capillaries in systemic sclerosis in the Indian population. Objectives: To study the patterns of nail fold capillaries using a hand-held dermoscope and to correlate these findings with cutaneous and systemic manifestations in patients with systemic sclerosis. Methods: Thirty-five patients were recruited in the study period between February 2014 and September 2015. All patients with systemic sclerosis were examined for cutaneous manifestations and dermoscopy of the nail fold capillaries was performed using Heine delta 20 dermoscope. Results: Our study had a female preponderance with the diffuse type of disease in 91% of patients. The most common abnormal nail fold dermoscopic pattern was dilated capillaries (91%). Scleroderma pattern was seen in 77% of our patients with the most common being active pattern. Early, active, and late type of the capillary pattern were associated with increased duration of disease but was not statistically significant. There was no significant association between capillary pattern and systemic manifestations. Conclusions: Majority (77%) of our patients had scleroderma patterns of which the active scleroderma pattern was the most common. There was no significant association between capillary pattern and systemic manifestations.