Skip to main content
Erschienen in: Die Dermatologie 1/2023

03.01.2023 | Dermatologische Diagnostik | CME Zertifizierte Fortbildung

Kapillarmikroskopie – Grundlagen und klinische Anwendung

verfasst von: R. Hasseli-Fräbel, Dr. med. W. Hermann, O. Sander, K. Triantafyllias

Erschienen in: Die Dermatologie | Ausgabe 1/2023

zum CME-Kurs Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Kapillarmikroskopie ist ein schnell und unkompliziert anwendbares differenzialdiagnostisches Tool, mit dem v. a. zwischen einem primären und sekundären Raynaud-Phänomen unterschieden werden kann. Bei verschiedenen Kollagenosen, vorrangig der systemischen Sklerose, ist sie sowohl zur Diagnostik als auch zur Aktivitäts- und Verlaufsbeurteilung unerlässlich. In der Kapillarmikroskopie feststellbare mikroangiopathische Muster lassen sich darüber hinaus auch bei weiteren Erkrankungen feststellen. In dieser Arbeit werden die Grundlagen der Untersuchung, deren Anwendung und klinische Relevanz dargestellt.
Literatur
1.
2.
Zurück zum Zitat Dima A, Berza I, Popescu DN, Parvu MI (2021) Nailfold capillaroscopy in systemic diseases: short overview for internal medicine. Rom J Intern Med 59(3):201–217 Dima A, Berza I, Popescu DN, Parvu MI (2021) Nailfold capillaroscopy in systemic diseases: short overview for internal medicine. Rom J Intern Med 59(3):201–217
3.
Zurück zum Zitat Smith V, Herrick AL, Ingegnoli F et al (2020) EULAR Study Group on Microcirculation in Rheumatic Diseases and the Scleroderma Clinical Trials Consortium Group on Capillaroscopy. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmun Rev 19(3):102458 CrossRef Smith V, Herrick AL, Ingegnoli F et al (2020) EULAR Study Group on Microcirculation in Rheumatic Diseases and the Scleroderma Clinical Trials Consortium Group on Capillaroscopy. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmun Rev 19(3):102458 CrossRef
4.
Zurück zum Zitat Cutolo M, Sulli A, Smith V (2013) How to perform and interpret capillaroscopy. Best Pract Res Clin Rheumatol 27(2):237–248 CrossRef Cutolo M, Sulli A, Smith V (2013) How to perform and interpret capillaroscopy. Best Pract Res Clin Rheumatol 27(2):237–248 CrossRef
5.
Zurück zum Zitat Geyer M, Vasile M, Hermann W (2014) Kapillarmikroskopie. Z Rheumatol 73(2):149–160 CrossRef Geyer M, Vasile M, Hermann W (2014) Kapillarmikroskopie. Z Rheumatol 73(2):149–160 CrossRef
6.
Zurück zum Zitat Sander O, Sunderkötter C, Kötter I, Wagner I, Becker M, Herrgott I, Schwarting A, Ostendorf B, Iking-Konert C, Genth E (2010) Capillaroscopy. Procedure and nomenclature. Z Rheumatol 69(3):253–262 CrossRef Sander O, Sunderkötter C, Kötter I, Wagner I, Becker M, Herrgott I, Schwarting A, Ostendorf B, Iking-Konert C, Genth E (2010) Capillaroscopy. Procedure and nomenclature. Z Rheumatol 69(3):253–262 CrossRef
7.
Zurück zum Zitat Smith V, Beeckman S, Herrick AL et al (2016) An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases. Rheumatology (Oxford) 55(5):883–890 CrossRef Smith V, Beeckman S, Herrick AL et al (2016) An EULAR study group pilot study on reliability of simple capillaroscopic definitions to describe capillary morphology in rheumatic diseases. Rheumatology (Oxford) 55(5):883–890 CrossRef
8.
Zurück zum Zitat Sulli A, Secchi ME, Pizzorni C, Cutolo M (2008) Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients. Ann Rheum Dis 67(6):885–887 CrossRef Sulli A, Secchi ME, Pizzorni C, Cutolo M (2008) Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients. Ann Rheum Dis 67(6):885–887 CrossRef
9.
Zurück zum Zitat Cutolo M, Sulli A, Pizzorni C, Accardo S (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27(1):155–160 Cutolo M, Sulli A, Pizzorni C, Accardo S (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27(1):155–160
10.
Zurück zum Zitat Sebastiani M, Manfredi A, Colaci M, D’Amico R, Malagoli V, Giuggioli D, Ferri C (2009) Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum 61(5):688–694 CrossRef Sebastiani M, Manfredi A, Colaci M, D’Amico R, Malagoli V, Giuggioli D, Ferri C (2009) Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum 61(5):688–694 CrossRef
11.
Zurück zum Zitat Sebastiani M et al (2012) Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Ann Rheum Dis 71(1):67–70 CrossRef Sebastiani M et al (2012) Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicentre validation study. Ann Rheum Dis 71(1):67–70 CrossRef
12.
Zurück zum Zitat Walker UA, Jaeger VK, Bruppacher KM, Dobrota R, Arlettaz L, Banyai M, Beron J, Chizzolini C, Groechenig E, Mueller RB, Spertini F, Villiger PM, Distler O (2018) Prospective evaluation of the capillaroscopic skin ulcer risk index in systemic sclerosis patients in clinical practice: a longitudinal, multicentre study. Arthritis Res Ther 20(1):239 CrossRef Walker UA, Jaeger VK, Bruppacher KM, Dobrota R, Arlettaz L, Banyai M, Beron J, Chizzolini C, Groechenig E, Mueller RB, Spertini F, Villiger PM, Distler O (2018) Prospective evaluation of the capillaroscopic skin ulcer risk index in systemic sclerosis patients in clinical practice: a longitudinal, multicentre study. Arthritis Res Ther 20(1):239 CrossRef
13.
Zurück zum Zitat Smith V et al (2011) 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 70:180–183 CrossRef Smith V et al (2011) 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 70:180–183 CrossRef
15.
Zurück zum Zitat Emrani Z, Karbalaie A, Fatemi A, Etehadtavakol M, Erlandsson B‑E (2017) Capillary density. An important parameter in nailfold capillaroscopy. Microvasc Res 109:7–18 CrossRef Emrani Z, Karbalaie A, Fatemi A, Etehadtavakol M, Erlandsson B‑E (2017) Capillary density. An important parameter in nailfold capillaroscopy. Microvasc Res 109:7–18 CrossRef
16.
Zurück zum Zitat Klein-Weigel P, Sander O, Reinhold S, Nielitz J, Steindl J, Richter JG (2021) Raynaud’s phenomenon—a vascular acrosyndrome that requires long-term care. Dtsch Arztebl Int 118:273–280 Klein-Weigel P, Sander O, Reinhold S, Nielitz J, Steindl J, Richter JG (2021) Raynaud’s phenomenon—a vascular acrosyndrome that requires long-term care. Dtsch Arztebl Int 118:273–280
17.
Zurück zum Zitat Saygin D, Highland KB, Tonelli AR (2019) Microvascular involvement in systemic sclerosis and systemic lupus erythematosus. Microcirculation 26(3):e12440 CrossRef Saygin D, Highland KB, Tonelli AR (2019) Microvascular involvement in systemic sclerosis and systemic lupus erythematosus. Microcirculation 26(3):e12440 CrossRef
18.
Zurück zum Zitat van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A et al (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747 CrossRef van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A et al (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747 CrossRef
19.
Zurück zum Zitat Caramaschi P, Canestrini S, Martinelli N, Volpe A, Pieropan S, Ferrari M et al (2007) Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity. Rheumatology (Oxford) 46(10):1566–1569 CrossRef Caramaschi P, Canestrini S, Martinelli N, Volpe A, Pieropan S, Ferrari M et al (2007) Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity. Rheumatology (Oxford) 46(10):1566–1569 CrossRef
20.
Zurück zum Zitat Ingegnoli F, Boracchi P, Gualtierotti R, Biganzoli EM, Zeni S, Lubatti C et al (2010) Improving outcome prediction of systemic sclerosis from isolated Raynaud’s phenomenon: role of autoantibodies and nail-fold capillaroscopy. Rheumatology (Oxford) 49(4):797–805 CrossRef Ingegnoli F, Boracchi P, Gualtierotti R, Biganzoli EM, Zeni S, Lubatti C et al (2010) Improving outcome prediction of systemic sclerosis from isolated Raynaud’s phenomenon: role of autoantibodies and nail-fold capillaroscopy. Rheumatology (Oxford) 49(4):797–805 CrossRef
21.
Zurück zum Zitat Arana-Ruiz JC, Silveira LH, Castillo-Martinez D, Amezcua-Guerra LM (2016) Assessment of nailfold capillaries with a handheld dermatoscope may discriminate the extent of organ involvement in patients with systemic sclerosis. Clin Rheumatol 35(2):479–482 CrossRef Arana-Ruiz JC, Silveira LH, Castillo-Martinez D, Amezcua-Guerra LM (2016) Assessment of nailfold capillaries with a handheld dermatoscope may discriminate the extent of organ involvement in patients with systemic sclerosis. Clin Rheumatol 35(2):479–482 CrossRef
22.
Zurück zum Zitat Cutolo M, Ferrone C, Pizzorni C, Soldano S, Seriolo B, Sulli A (2010) Peripheral blood perfusion correlates with microvascular abnormalities in systemic sclerosis: a laser-Doppler and nailfold videocapillaroscopy study. J Rheumatol 37(6):1174–1180 CrossRef Cutolo M, Ferrone C, Pizzorni C, Soldano S, Seriolo B, Sulli A (2010) Peripheral blood perfusion correlates with microvascular abnormalities in systemic sclerosis: a laser-Doppler and nailfold videocapillaroscopy study. J Rheumatol 37(6):1174–1180 CrossRef
23.
Zurück zum Zitat Smith V, Decuman S, Sulli A, Bonroy C, Piettte Y, Deschepper E et al (2012) Do worsening scleroderma capillaroscopic patterns predict future severe organ involvement? A pilot study. Ann Rheum Dis 71(10):1636–1639 CrossRef Smith V, Decuman S, Sulli A, Bonroy C, Piettte Y, Deschepper E et al (2012) Do worsening scleroderma capillaroscopic patterns predict future severe organ involvement? A pilot study. Ann Rheum Dis 71(10):1636–1639 CrossRef
24.
Zurück zum Zitat Ingegnoli F, Ardoino I, Boracchi P, Cutolo M (2013) Nailfold capillaroscopy in systemic sclerosis: data from the EULAR scleroderma trials and research (EUSTAR) database. Microvasc Res 89:122–128 CrossRef Ingegnoli F, Ardoino I, Boracchi P, Cutolo M (2013) Nailfold capillaroscopy in systemic sclerosis: data from the EULAR scleroderma trials and research (EUSTAR) database. Microvasc Res 89:122–128 CrossRef
25.
Zurück zum Zitat Markusse IM, Meijs J, de Boer B, Bakker JA, Schippers HPC, Schouffoer AA et al (2017) Predicting cardiopulmonary involvement in patients with systemic sclerosis: complementary value of nailfold videocapillaroscopy patterns and disease-specific autoantibodies. Rheumatology (Oxford) 56(7):1081–1088 Markusse IM, Meijs J, de Boer B, Bakker JA, Schippers HPC, Schouffoer AA et al (2017) Predicting cardiopulmonary involvement in patients with systemic sclerosis: complementary value of nailfold videocapillaroscopy patterns and disease-specific autoantibodies. Rheumatology (Oxford) 56(7):1081–1088
26.
Zurück zum Zitat Klein-Weigel PF, Sunderkötter C, Sander O (2016) Nailfold capillaroscopy microscopy—an interdisciplinary appraisal. Vasa 45:353–364 CrossRef Klein-Weigel PF, Sunderkötter C, Sander O (2016) Nailfold capillaroscopy microscopy—an interdisciplinary appraisal. Vasa 45:353–364 CrossRef
27.
Zurück zum Zitat Koenig M, Joyal F, Fritzler MJ et al (2008) Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud’s phenomenon to systemic sclerosis. A twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum 58:3902–391214 CrossRef Koenig M, Joyal F, Fritzler MJ et al (2008) Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud’s phenomenon to systemic sclerosis. A twenty-year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis. Arthritis Rheum 58:3902–391214 CrossRef
28.
Zurück zum Zitat Belch J, Carlizza A, Carpentier PH et al (2017) ESVM guidelines—the diagnosis and management of Raynaud’s phenomenon. Vasa 46:413–423 CrossRef Belch J, Carlizza A, Carpentier PH et al (2017) ESVM guidelines—the diagnosis and management of Raynaud’s phenomenon. Vasa 46:413–423 CrossRef
29.
Zurück zum Zitat Bernardino V, Rodrigues A, Lladó A et al (2020) Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic. Rheumatol Int 40:295–301 CrossRef Bernardino V, Rodrigues A, Lladó A et al (2020) Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic. Rheumatol Int 40:295–301 CrossRef
30.
Zurück zum Zitat Sebastiani M, Triantafyllias K, Manfredi A, Gonzalez-Gay MA, Palmou-Fontana N, Cassone G et al (2019) Nailfold capillaroscopy characteristics of antisynthetase syndrome and possible clinical associations: results of a multicenter international study. J Rheumatol 46(3):279–284 CrossRef Sebastiani M, Triantafyllias K, Manfredi A, Gonzalez-Gay MA, Palmou-Fontana N, Cassone G et al (2019) Nailfold capillaroscopy characteristics of antisynthetase syndrome and possible clinical associations: results of a multicenter international study. J Rheumatol 46(3):279–284 CrossRef
31.
Zurück zum Zitat Arvanitaki A, Giannakoulas G, Triantafyllidou E et al (2021) Peripheral microangiopathy in precapillary pulmonary hypertension: a nailfold video capillaroscopy prospective study. Respir Res 22:27 CrossRef Arvanitaki A, Giannakoulas G, Triantafyllidou E et al (2021) Peripheral microangiopathy in precapillary pulmonary hypertension: a nailfold video capillaroscopy prospective study. Respir Res 22:27 CrossRef
32.
Zurück zum Zitat Maldonado G, Guerrero R, Paredes C, Ríos C (2017) Nailfold capillaroscopy in diabetes mellitus. Microvasc Res 112:41–46 CrossRef Maldonado G, Guerrero R, Paredes C, Ríos C (2017) Nailfold capillaroscopy in diabetes mellitus. Microvasc Res 112:41–46 CrossRef
33.
Zurück zum Zitat Seguro Paula F, Amorim Ferreira I, Amaral Carapeto M, Delgado Alves J (2016) Systemic sclerosis-related changes on nailfold videocapillaroscopy in genetic and metabolic myopathies. Rheumatology (Oxford) 55(10):1911–1912 CrossRef Seguro Paula F, Amorim Ferreira I, Amaral Carapeto M, Delgado Alves J (2016) Systemic sclerosis-related changes on nailfold videocapillaroscopy in genetic and metabolic myopathies. Rheumatology (Oxford) 55(10):1911–1912 CrossRef
Metadaten
Titel
Kapillarmikroskopie – Grundlagen und klinische Anwendung
verfasst von
R. Hasseli-Fräbel
Dr. med. W. Hermann
O. Sander
K. Triantafyllias
Publikationsdatum
03.01.2023
Verlag
Springer Medizin
Erschienen in
Die Dermatologie / Ausgabe 1/2023
Print ISSN: 2731-7005
Elektronische ISSN: 2731-7013
DOI
https://doi.org/10.1007/s00105-022-05091-5

Weitere Artikel der Ausgabe 1/2023

Die Dermatologie 1/2023 Zur Ausgabe

Update Innere Medizin

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.