Intravital microscopy andcapillaroscopica lly guided nail fold biopsy inscleroderma

AbstractObjectives-To describe the frequency,extent, and nature of microvascularlesions in patients with scleroderma by means of capillaroscopy and capillaro-scopically guidednail fold biopsy, andtodeterminethediagnostic value ofthe two methodsandthepathophysiologicalsigni-ficanceofthelesionsdescribed.Methods-Acohort study was madeof 24 consecutivepatientswithsclerodermaand 10 healthy controls, using standardisedclinical, serological, capillaroscopic, andhistological (nailfoldbiopsy)techniques.Results-Al patients with sclerodermahaddistinct lesions ofthe microvascularsystem. Capillaroscopy revealed morethan 90%ofthepatients to havethetypicalsclerodermapattern.Histologically, thesechanges most frequently consisted ofsplitting ofthe basal lamina, broadeningoftheperivascularconnectivetissue,peri-vascular round cell infiltrations, andimmunoglobulindeposits (eachin60-75%ofthepatients) . Electronmicroscopy was the most sensitive methodofhistologicalemination, detecting abnormalities in87-5% ofpatients; with light microscopyand immunohistochemical techniques,abnormalities