Title: Capillaroscopic nail fold changes in collagen vascular diseases: A prospective observational study from a tertiary care teaching hospital in Western India

Objective: To examine nail changes with capillaroscopy in patients with collagen vascular diseases. 

Materials and Methods: In this prospective observational study, patients with collagen vascular diseases presented to dermatology outpatient department of a tertiary care centre were subjected to capillaroscopy. Structural and morphological abnormalities in these patients were noted. 

Results: Fifty patients (Mean age 38.2 years; 86% females) with mean disease duration of 1.96 years were included. Patients with systemic sclerosis and systemic lupus erythematosus constituted 34% and 32% patients respectively. Twenty-two (44%) patients had presence of dilated nail fold capillary loops. Out of 17 patients with systemic sclerosis, 15(88.23%) and 14(87.5%) showed dilated nail fold capillary loops and capillary drop-pouts respectively. Capillary dropouts were observed in 14(82.35%) patients. Raynaud’s phenomenon, splinter haemorrhage and fingertip scarring were observed in 11(64.71%), six (35.29%) and 33(17.65%) patients respectively. Ragged cuticle was observed in four (25%) patients with systemic lupus erythematosus. 

Conclusion: In our study, systemic sclerosis and systemic lupus erythematosus were two most common disorders. Dilated nail fold capillary loops/giant capillaries were the most common observation in overall population. Dilated nail fold capillary loops, capillary dropouts, Raynaud’s phenomenon, splinter haemorrhage and fingertip scarring were common in patients with systemic sclerosis.