Prevalence, distribution and associations of the scleroderma capillaroscopic patterns: new insights from the Italian SPRING-SIR registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To assess the relationship between disease duration and the prevalence/distribution of nailfold videocapillaroscopy (NVC) patterns, named according to the current classification as 'early', 'active' and 'late', in a large cohort of systemic sclerosis (SSc) patients. METHODS: A cross-sectional analysis was conducted on 1689 patients undergoing standardized NVC. Clinical-serological data and treatments were collected. Statistical comparisons and multivariable logistic regression models were applied, including analyses based on disease duration. RESULTS: The prevalence of NVC patterns was as follows: 'early' 21.6%, 'active' 47.4%, 'late' 25.7% and normal/non-specific 5.3%. The distribution by disease duration showed that the three main patterns were always present. While the 'early' and 'active' progressively decreased (from 30.3% and 51.9% in patients with ≤5 yrs, to 14.6% and 43.5% in those >10 yrs, P < 0.01), the 'late' pattern increased from 13.2% (≤5 yrs) to 36.0% (>10 yrs) (P < 0.001) and was associated with internal organ involvement, anti-topoisomerase antibodies and more therapies (P < 0.01). Conversely, the 'early' and 'active' patterns were associated with the limited-cutaneous subset (P < 0.01) and anti-centromere antibodies (P < 0.001). Multivariable analysis confirmed a strong association between the 'late' pattern and skin/peripheral vascular involvement. Notably, the presence of the 'late' pattern in patients with ≤2 yrs (10.9%) was significantly associated with scleroderma renal crisis (P = 0.012). CONCLUSION: SSc-NVC patterns are not strictly time-dependent and can be observed at any stage of the disease, suggesting that microvascular damage progression is heterogeneous across different disease periods. Therefore, a revised classification of NVC changes considering both disease duration and NVC severity could improve its prognostic accuracy.
Source: Lara D. Veeken
Authors: Rossella De Angelis, Clodoveo Ferri, Edoardo Cipolletta, Valeria Riccieri, Marco Di Battista, Gianluigi Bajocchi, Silvia Bellando-Randone, Cosimo Bruni, Martina Orlandi, Giovanni Zanframundo, Roberta Foti, Giovanna Cuomo, Alarico Ariani, Edoardo Rosato, Gemma Lepri, Francesco Girelli, Elisabetta Zanatta, Silvia Laura Bosello, Ilaria Cavazzana, Francesca Ingegnoli, Maria De Santis, Fabio Cacciapaglia, Giuseppe Murdaca, Giuseppina Abignano, Giorgio Pettiti, Alessandra Della Rossa, Maurizio Caminiti, Anna Maria Iuliano, Giovanni Ciano, Lorenzo Beretta, Gianluca Bagnato, Ennio Lubrano, Ilenia De Andres, Luca Idolazzi, Marta Saracco, Cecilia Agnes, Corrado Campochiaro, Marco Fornaro, Federica Lumetti, Amelia Spinella, Emanuele Cocchiara, Giacomo De Luca, Veronica Codullo, Elisa Visalli, Carlo Iandoli, Antonietta Gigante, Greta Pellegrino, Erika Pigatto, Maria Grazia Lazzaroni, Enrico De Lorenzis, Francesca Motta, Antonio Tonutti, Gianna Mennillo, Giuseppa Pagano-Mariano, Federica Furini, Licia Vultaggio, Simone Parisi, Clara Lisa Peroni, Gerolamo Bianchi, Enrico Fusaro, Gian Domenico Sebastiani, Marcello Govoni, Salvatore D’Angelo, Franco Cozzi, Franco Franceschini, Serena Guiducci, Dilia Giuggioli, Lorenzo Dagna, Andrea Doria, Carlo Salvarani, Florenzo Iannone, Marco Matucci-Cerinic, SPRING-SIR (Systemic Sclerosis Progression Investigation group of the Italian Society for Rheumatology), Amato Giorgio, Benenati Alessia, Calabrese Francesca, Carignola Renato, Dall’Ara Francesca, De Cata Angelo, Doveri Marica, Romeo Nicoletta, Magnani Luca, Sambataro Gianluca, Talotta Rossella, Carlo Alberto Scirè, Gianpiero Landolfi, Davide Rozza, Greta Carrara, Anna Zanetti
Institutions: Marche Polytechnic University, University of Modena and Reggio Emilia, Sapienza University of Rome, University of Pisa, Azienda Sanitaria Unità Locale di Reggio Emilia, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Policlinico San Matteo Fondazione, University of Catania, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", University of Campania "Luigi Vanvitelli", University of Parma, Ospedale di Parma, Ospedale G.B. Morgagni - L.Pierantoni, University of Padua, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia, University of Brescia, University of Milan, Humanitas University, IRCCS Humanitas Research Hospital, Ospedale Generale Regionale Francesco Miulli, Ospedale Policlinico San Martino, University of Genoa, University of Basilicata, Ospedale San Carlo, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Azienda Ospedaliera San Camillo-Forlanini, Carlo Forlanini Hospital, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Messina, University of Molise, Ospedale Garibaldi, University of Verona, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, University of Bari Aldo Moro, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Ospedale San Bassiano, University of Ferrara, Arcispedale Sant'Anna, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417356752