Computer assisted evaluation of skin capillary density supports the hypothesis of microvascular shunting in erythromelalgia

This thesis focuses on evaluation and analysis of capillary microcirculatory changes in the skin, that can be improved and extended by computer assisted video microscopy. Capillary microscopy has been used extensively, both in clinical practice and research, to study different phenomena in the microvasculature of the skin, mainly in the nailfold of fingers and toes where a large portion of the capillary loop can be observed.In the majority of the different skin regions, the nutritive capillary network approaches the skin surface perpendicularly and capillary microscopy in these sites reveals the apex of the capillary loop as a dark spot. The main approach in this work has been to study a large ensemble of capillary loops, in order to apply statistical and planar models whilst, at the same time, obtaining spatial parameters related to the capillary localization.The statistical models of proximity are based on nearest neighbour methods and triangulation techniques. The main reason for introducing these models is because of their capability to characterize the heterogeneity of the capillary ensemble.A computer assisted video microscopy system, that enables both capturing and evaluating of capillary bed images, was assembled and was, thereafter, successfully used in laboratory and clinical studies.