Aktuelle Dermatologie 2020; 46(04): 143-147
DOI: 10.1055/a-1072-6739
Übersicht

Kapillarmikroskopie – wann, wie und wofür?

Capillaroscopy – When, How and for What?
O. Sander
1   Poliklinik und Funktionsbereich für Rheumatologie & Hiller Forschungszentrum Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
,
C. Sunderkötter
2   Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
› Author Affiliations

Zusammenfassung

Die Übersichtsarbeit stellt die aktuelle Datenlage zur Bedeutung der Kapillarmikroskopie in der nicht invasiven Abklärung von Akroperfusionsstörungen und insbesondere der Früherkennung der Sklerodermie/Systemsklerose dar. Hier sind die Kenntnis des Normalbefundes und die Differenzierung zum sklerodermietypischen Muster entscheidend. Aber auch für die Verlaufsbeurteilung und Prognoseabschätzung der Sklerodermie ist die Kapillarmikroskopie ein sinnvolles Instrument. Die solideste Prädiktion kann dabei die Kapillardichte liefern.

Abstract

The review presents the current data on the importance of capillaroscopy in the non-invasive clarification of acroperfusion disorders and in particular the early detection of scleroderma/systemic sclerosis. Here, in particular the detection of the normal findings and the differentiation to scleroderma typical pattern are crucial. However, capillary microscopy is also a useful tool for assessing the course and prognosis of scleroderma. Capillary density delivers the most solid prediction therefore.



Publication History

Article published online:
06 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 
  • Literatur

  • 1 Sander O, Sunderkötter C, Kötter I. et al. Kapillarmikroskopie Durchführung und Nomenklatur. Z Rheumatol 2010; 69: 253-262
  • 2 Klein-Weigel PF, Sunderkötter C, Sander O. Nailfold capillaroscopy microscopy – an interdisciplinary appraisal. Vasa 2016; 45: 353-364
  • 3 Gutierrez M, Bertolazzi C, Tardella M. et al. Interreader reliability in assessment of nailfold capillary abnormalities by beginners: pilot study of an intensive videocapillaroscopy training program. J Rheumatol 2012; 39: 1248-1255
  • 4 Ingegnoli F, Ughi N, Dinsdale G. et al. On behalf of the EULAR Study Group on Microcirculation in RheumaticDiseases An international SUrvey on non iNvaSive tecHniques to assess the mIcrocirculation in patients with RayNaud’s phEnomenon (SUNSHINE survey). Rheumatol Int 2017; 37: 1879-1890
  • 5 Boulon C, Blaise S, Lazareth I. et al. Reproducibility of the scleroderma pattern assessed by wide-field capillaroscopy in subjects suffering from Raynaudʼs phenomenon. Rheumatology 2017; 56: 1780-1783
  • 6 Sunderkötter C, Riemekasten G. Raynaud-Phänomen in der Dermatologie Teil 1: Pathophysiologie und Diagnostik. Hautarzt 2006; 57: 819
  • 7 Sander O, Iking-Konert C, Ostendorf B. Taschenatlas Kapillarmikroskopie. 1. Auflage, EX-Mktg-0060-31012008 Freiburg: Actelion; 2008
  • 8 Dechant C, Sander O. Kapillarmikroskopie. Arthritis + Rheuma 2009; 29: 179-185
  • 9 Sander O. Kapillarmikroskopie in Klinik, Praxis und Forschung. Akt Rheumatol 2010; 35: 325-329
  • 10 Sander O. Was kann die Kapillarmikroskopie leisten?. Internist Prax 2013; 53: 1-17
  • 11 Richter J, Iking-Konert C, Schneider M. et al. Kapillarmikroskopie – Ein Update. Z Rheumatol 2013; 72: 145-150
  • 12 Richter JG, Klein-Weigel P, Brinks R. et al. Geschlechtsspezifische Unterschiede bei Gesunden und Patienten mit entzündlich-rheumatischen Erkrankungen in der Kapillarmikroskopie. Z Rheumatol 2014; 73: 615-622
  • 13 Klein-Weigel P, Richter JG, Sander O. Schwerpunktthema II Geschlechtsspezifische Befunde in der Kapillarmikroskopie. Gefaessmedizin.net 2015; 11: 11-13
  • 14 Sander O, Dechant C, Sunderkötter C. et al. Kapillarmikroskopie. Akt Rheumatol 2016; DOI: 10.1055/s-0042-105866.
  • 15 Sulli A, Secchi ME, Pizzorni C. et al. Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients. Ann Rheum Dis 2008; 67: 885-887
  • 16 Sebastiani M, Manfredi A, Colaci M. et al. Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum 2009; 61: 688-694
  • 17 Sebastiani M, Manfredi A, Vukatana G. et al. Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Ann Rheum Dis 2012; 71: 67-70
  • 18 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 Res Ther 2014; 16: 462
  • 19 Andracco R, Irace R, Zaccara E. et al. The cumulative number of micro-haemorrhages and micro-thromboses 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: 133
  • 20 Smith V, De Keyser F, Pizzorni C. et al. Nailfold capillaroscopy for day-to-day clinical use: construction of a simple scoring modality as a clinical prognostic index for digital trophic lesions. Ann Rheum Dis 2011; 70: 180-183
  • 21 Paxton D, Pauling JD. Does nailfold capillaroscopy help predict future outcome in systemic sclerosis? A systemic literature review. Semin Arthritis Rheum 2018; 48: 482-494
  • 22 Cutolo M, Melsens K, Herrick AL. et al. EULAR Study Group on Microcirculation in Rheumatic Diseases Reliability of simple capillaroscopic definitions in describing capillary morphology in rheumatic diseases. Rheumatology 2018; 57: 757-759
  • 23 Cutolo M, Grassi W, Matucci Cerinic M. Raynaudʼs phenomenon and the role of capillaroscopy. Arthritis Rheum 2003; 48: 3023-3030
  • 24 Ingegnoli F, Boracchi P, Gualtierotti R. et al. Improving outcome prediction of systemic sclerosis from isolated Raynaudʼs phenomenon: role of autoantibodies and nail-fold capillaroscopy. Rheumatology 2010; 49: 797-805
  • 25 Sander O, Schroeder M, Ostendorf B. et al. Capillary Microscopy: A Cross-Sectional Study in the Population. Arthritis Rheum 2010; 62: 1615
  • 26 Ingegnoli F, Boracchi P, Gualtierotti R. et al. Prognostic model based on nailfold capillaroscopy for identifying Raynaudʼs phenomenon patients at high risk for the development of a scleroderma spectrum disorder: PRINCE (Prognostic Index for Nailfold Capillaroscopic Examination). Arthritis Rheum 2008; 58: 2174-2182
  • 27 Sander O, Dechant C, Czihal M. Raynaud-Syndrom. Arthritis + Rheuma 2018; 38: 195-201
  • 28 Koenig M, Joyal F, Fritzler MJ. et al. Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaudʼs phenomenon to systemic sclerosis: a twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum 2008; 58: 3902-3912
  • 29 van den Hoogen F, Khanna D, Fransen J. et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis 2013; 72: 1747-1755
  • 30 Dinsdale G, Anniek M, van Roon AM. et al. Longitudinal nailfold capillaroscopy tracking of microangiopathic changes in systemic sclerosis. Rheumatology 2018; 57: 1554
  • 31 Miniati I, Guiducci S, Conforti ML. et al. Autologous stem cell transplantation improves microcirculation in systemic sclerosis. Ann Rheum Dis 2009; 68: 94-98
  • 32 Cutolo M, Herrick AL, Distler O. et al., CAP Study Investigators. Nailfold Videocapillaroscopic Features and Other Clinical Risk Factors for Digital Ulcers in Systemic Sclerosis: A Multicenter, Prospective Cohort Study. Arthritis Rheumatol 2016; 68: 2527-2539
  • 33 Avouac J, Lepri G, Smith V. et al. Sequential nailfold videocapillaroscopy examinations have responsiveness to detect organ progression in systemic sclerosis. Semin Arthritis Rheum 2017; 47: 86-94
  • 34 Corrado A, Correale M, Mansueto N. et al. Nailfold capillaroscopic changes in patients with idiopathic pulmonary arterial hypertension and systemic sclerosis-related pulmonary arterial hypertension. Microvasc Res 2017; 114: 46-51
  • 35 Emrani Z, Karbalaie A, Fatemi A. et al. Capillary density. An important parameter in nailfold capillaroscopy. Microvasc Res 2017; 109: 7-18
  • 36 Richter JG, Sander O, Schneider M. et al. Diagnostic algorithm for Raynaud’s phenomenon and vascular skin lesions in systemic lupus erythematosus. Lupus 2010; 19: 1087-1095
  • 37 Shenavandeh S, Habibi S. Nailfold capillaroscopic changes in patients with systemic lupus erythematosus. Correlations with disease activity, skin manifestation and nephritis. Lupus 2017; 26: 959-966
  • 38 Cutolo M, Melsens K, Wijnant S. et al. Nailfold capillaroscopy in systemic lupus erythematosus. A systematic review and critical appraisal. Autoimmun Rev 2018; 17: 344-352
  • 39 Sebastiani M, Triantafyllias K, Manfredi A. et al. Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and Possible Clinical Associations: Results of a Multicenter International Study. J Rheumatol 2019; 46: 279-284
  • 40 Dinsdale G, Peytrignet S, Moore T. et al. The assessment of nailfold capillaries: comparison of dermoscopy and nailfold videocapillaroscopy. Rheumatology (Oxford) 2018; 57: 1115-1116
  • 41 Dinsdale G, Roberts C, Moore T. et al. Nailfold capillaroscopy – how many fingers should be examined to detect abnormality?. Rheumatology (Oxford) 2019; 58: 284-288
  • 42 Karbalaie A, Abtahi F, Fatemi A. et al. Elliptical broken line method for calculating capillary density in nailfold capillaroscopy: Proposal and evaluation. Microvasc Res 2017; 113: 1-8
  • 43 Urwin SG, Griffiths B, Allen J. et al. Quantification of differences between nailfold capillaroscopy images with a scleroderma pattern and normal pattern using measures of geometric and algorithmic complexity. Physiol Meas 2017; 38: N32 DOI: 10.1088/1361-6579/38/2/N32.
  • 44 Aguirre J, Hindelang B, Berezhnoi A. et al. Assessing nailfold microvascular structure with ultra-wideband raster-scan optoacoustic mesoscopy. Photoacoustics 2018; 10: 31-37
  • 45 Berks M, Dinsdale G, Murray A. et al. Automated structure and flow measurement – a promising tool in nailfold capillaroscopy. Microvasc Res 2018; 118: 173-177
  • 46 Gruartmoner G, Mesquida J, Ince C. Microcirculatory monitoring in septic patients: Where do we stand?. Med Intensiva 2017; 41: 44-52
  • 47 Thevissen K, Gyselaers W. Capillaroscopy in pregnancy. Expert Rev Med Devices 2017; 14: 961-967
  • 48 Hsu PC, Liao PY, Chang HH. et al. Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy. Medicine (Baltimore) 2016; 95: e5714
  • 49 Sander O, Schwitalla JC, Ringelstein M. et al. Capillary Microscopy in Caucasians with Idiopathic Moyamoya Angiopathy. Microcirculation, submitted