Correlation of nailfold capillaroscopy findings with history of digital ulcer on same finger: Results of SCLEROCAP study

Carine Boulon (1) , Fanny Velardo (2) , Sophie Blaise (3) , Marion Mangin (1) , Joelle Decamps-Le Chevoir (4) , Patricia Senet (5) , Isabelle Lazareth (4) , Nathalie Baudot (5) , Laurent Tribout (5) , Bernard Imbert (3) , François-Xavier Lapebie (6) , Loubna Dari (1) , Philippe Lacroix (7, 8) , Marie-Elise Truchetet (9) , Julien Seneschal (10) , Anne Solanilla , Estibaliz Lazaro (11) , Isabelle Quéré (12, 13) , Marc-Antoine Pistorius (14) , Julien Asselineau (2) , Edouard Lhomme (2) , Patrick Carpentier (15) , Joël Constans (1)

1 CHU Bordeaux
2 ISPED - Institut de Santé Publique, d'Epidémiologie et de Développement
3 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
4 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
5 CHU Tenon [AP-HP]
6 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
7 EpiMaCT - Epidémiologie des Maladies Chroniques en zone tropicale
8 Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]
9 Hôpital Pellegrin
10 Service de dermatologie Hôpital Saint-André Bordeaux
11 Hôpital Haut-Lévêque [CHU Bordeaux]
12 CHRU Montpellier - Hôpital Saint Eloi
13 IDESP - Institut Desbrest de santé publique
14 Hôtel-Dieu de Nantes
15 Centre hospitalier Saint-Joseph [Paris]

Systemic sclerosis may be complicated by digital ulcers. Nailfold capillaroscopy on one finger might reflect an increased risk of digital ulcer (DU). In the present study we studied the correlations between a history of ulcer and capillary findings on the finger. Method: This study is part of Sclerocap, a multicenter study aiming at validating prospectively the prognostic value of Maricq's and Cutolo's capillaroscopic classifications during a three-year longitudinal follow-up. A history of past or present digital ulcer was recorded at inclusion and nailfold capillaroscopy was performed. Elementary findings as well as Cutolo and Maricq's classifications were assessed. Results: 387 patients were included in Sclerocap (327 females, 60 males) and 3096 fingers were examined by capillaroscopy at inclusion: 316 fingers (10%) belonging to 113 patients had a history of DU. Late Cutolo's stage was statistically correlated with a history of DU, both by univariate: OR 2.08 [1.09-3.96] and multivariate analysis: OR 1.97 [1.06-3.63]. Among the elemental abnormalities, only edema and decreased capillary density were correlated with a history of DU by multivariate analysis: respectively OR 1.92 [1.17-3.16] and 0.65 [0.49-0.85]. Conclusion: This cross-sectional study in a large cohort of patients with systemic sclerosis shows a correlation between a history of digital ulcer and edema, a decrease in capillary density and the late stage in Cutolo's classification. The extent of capillary abnormalities on one finger is associated with a history of local digital ulcer. Capillaroscopy might be used to predict the risk of DU but these results need first to be confirmed by prospective studies.

Mots clés: Capillaroscopy; Digital ulcer; Finger ischemia; Microcirculation; Systemic sclerosis; Capillaroscopy

Domaines: Santé publique et épidémiologie

Carine Boulon, Fanny Velardo, Sophie Blaise, Marion Mangin, Joelle Decamps-Le Chevoir, et al.. Correlation of nailfold capillaroscopy findings with history of digital ulcer on same finger: Results of SCLEROCAP study. Microvascular Research, 2022, 142, pp.104365. ⟨10.1016/j.mvr.2022.104365⟩. ⟨hal-03681824⟩