Nailfold capillaroscopy in psoriatic domains according to Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)

Introduction Psoriasis and psoriatic arthritis (PSA) are chronic immune-mediated diseases associated with chronic low-grade systemic inflammation, leading to endothelial cells proliferation and vascular insufficiency, which lead to abnormalities in capillaries. Aim To assess the patterns of nailfold capillaroscopy in psoriatic domains and compare these patterns with control groups. Patients and methods A total of 150 patients with psoriasis and PSA were subdivided into five subgroups: group 1 included 30 patients with predominant peripheral PSA; group 2 included 30 patients with predominant peripheral PSA and/or dactylitis, as well as enthesitis; group 3 included 30 patients with predominant axial affection; group 4 included 30 patients with predominant axial affection and/or dactylitis, as well as enthesitis; and group 5 included 30 patients with predominant skin and/or nail affection. In addition, group 6 was the control group, which included 25 patients with rheumatoid arthritis, and group 7 included 25 patients with systemic sclerosis. Results Capillary density was statistically significantly lower among group 7 and higher among group 5. Tortuous capillaries were statistically significantly higher among group 2. However, group 5 had the least tortuous capillaries. Microhemorrhage, angiogenesis, and subpapillary venous plexus were statistically significantly higher among group 7. However, there was no statistically significant difference among the psoriatic groups regarding microhemorrhage, whereas angiogenesis was statistically significantly lower among group 5. Conclusion PSA showed low capillary density, increased tortuous capillaries and capillary hemorrhage, more visibility of subpapillary venous plexus, and dilated capillaries in comparison with patients with rheumatoid arthritis, whereas systemic sclerosis had specific pattern.