Nailfold capillaroscopic changes in Egyptian patients with psoriatic arthritis in comparison to rheumatoid arthritis

• Main Authors: Adel M. Ali, Sherin M. Hamza, Fatma M. Aboud, Nouran M. El-Shahat
• Format: Article
• Language: English
• Published: Elsevier 2019-10-01
• Series: Egyptian Rheumatologist
• Online Access: http://www.sciencedirect.com/science/article/pii/S1110116419300225

Introduction: Nailfold capillaroscopy (NFC) is simple technique for assessment of the microvascular changes recognized in both diseases can be used in helping the differential diagnosis. Aim of the work: To determine the nailfold capillaroscopic changes in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) patients and their relation to disease activity. Patients and methods: Twenty PsA and 20 RA patients were studied. Disease activity score (DAS28) was assessed. NFC examination was done to all patients. Results: There was a significant decrease in capillary density (8.65 ± 1.39 vs 9.5 ± 1/mm; p = 0.02) and increase in mean capillary width (28.4 ± 7.8 μm vs 22.9 ± 4.3 μm; p = 0.01) in PsA than RA patients. Hairpin, organized capillaries were found in all RA patients while in PsA patients tortuous capillaries were found in 100% and disorganized capillaries in 35%. A significant increase in hemorrhages (65% versus 10%; p < 0.0001) was present in PsA compared to RA patients. In PsA patients, there was a significant correlation between the tender joints count (TJC) and the width of the capillaries (r = 0.44, p = 0.047) and inversely with the capillary density (r = −0.46, p = 0.04). The TJC significantly associated with the capillary disorganization (p = 0.035). A significant negative correlation between CRP titer and arterial diameter of capillaries (r = −0.45, p = 0.045). Conclusion: The nailfold capillaroscopy in RA patients had no specific changes, While in PsA patients showed low density, dilated, tortuous and disorganized capillaries and hemorrhages. So, Nailfold capillaroscopy can be used in the differentiation between both diseases. NFC abnormalities may be related to the disease activity. Keywords: Capillaroscopy, Psoriatic arthritis, Rheumatoid arthritis, Disease activity