1
|
Bica PF, Matucci-Cerinic C, Hysa E, Cere A, Rosina S, Volpi S, Caorsi R, Sulli A, Paolino S, Smith V, Cutolo M, Gattorno M. Nailfold videocapillaroscopy in patients with deficiency of adenosine deaminase 2 (DADA2): a case-control study. Pediatr Rheumatol Online J 2025; 23:58. [PMID: 40410857 PMCID: PMC12100850 DOI: 10.1186/s12969-025-01104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 04/27/2025] [Indexed: 05/25/2025] Open
Abstract
BACKGROUND Deficiency of adenosine deaminase 2 (DADA2) is a rare monogenic autoinflammatory disease mainly characterized by the presence of systemic inflammation and vascular manifestations such as vasculitis and early-onset stroke. Raynaud's phenomenon (RP) can occur in up to 22% of DADA2 patients. The aim of this work was to investigate the microvascular status of DADA2 patients by the mean of nailfold videocapillaroscopy (NVC) comparing them with adequate healthy controls (HC) and primary RP patients. FINDINGS NVC data of 9 DADA2 patients (mean age 18 ± 6 y) followed at the Children Gaslini Institute were retrospectively retrieved and compared to age and sex cross matched 11 HCs and 7 with primary RP patients. The NVC parameters were classified according to the EULAR SG Fast Track Algorithm and distinguished between scleroderma-pattern (giant capillaries and/or loss of capillaries combined with abnormally shaped capillaries) and non-scleroderma patterns (non-specific NVC alterations). In all DADA2 patients, NVC showed the presence of non-specific alterations (capillaries with dilations in 100% of cases, abnormal shapes in 23% and microhaemorrhages in 11% of patients). The capillary density was normal and no scleroderma pattern was found. Between DADA2, RP patients and HC, no significant differences in the rate of each microvascular finding were detected (p values NS). CONCLUSIONS This is the first report on NVC in DADA2 patients. Only non-specific abnormalities were found, characterized mainly by capillaries' dilations, but in the absence of giant capillaries. However, larger studies are needed to definitively disclose the microvascular status in DADA2 disease.
Collapse
Affiliation(s)
| | - Caterina Matucci-Cerinic
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
- Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, Genoa, 16147, Italy.
| | - Elvis Hysa
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Andrea Cere
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia Rosina
- Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, Genoa, 16147, Italy
| | - Stefano Volpi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, Genoa, 16147, Italy
| | - Roberta Caorsi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, Genoa, 16147, Italy
| | - Alberto Sulli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DIMI), University of Genova, IRCCS San Martino Polyclinic, Genova, Italy
| | - Sabrina Paolino
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DIMI), University of Genova, IRCCS San Martino Polyclinic, Genova, Italy
| | - Vanessa Smith
- Department of Internal Medicine, University of Ghent, Ghent University Hospital, Ghent, Belgium
- Department of Rheumatology, University of Ghent, Ghent University Hospital, Ghent, Belgium
- Unit for Molecular Immunology and Inflammation, Flemish Institute for Biotechnology, Inflammation Research Center, Ghent, Belgium
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties (DIMI), University of Genova, IRCCS San Martino Polyclinic, Genova, Italy
| | - Marco Gattorno
- Rheumatology and Autoinflammatory diseases, IRCCS Istituto Giannina Gaslini, Largo Gaslini 5, Genoa, 16147, Italy
| |
Collapse
|
2
|
Screm G, Mondini L, Confalonieri P, Salton F, Trotta L, Barbieri M, Mari M, Reccardini N, Della Porta R, Kodric M, Bandini G, Hughes M, Bellan M, Lerda S, Confalonieri M, Ruaro B. Nailfold Capillaroscopy Analysis Can Add a New Perspective to Biomarker Research in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. Diagnostics (Basel) 2024; 14:254. [PMID: 38337770 PMCID: PMC10854947 DOI: 10.3390/diagnostics14030254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), all of which are characterised by inflammation of small-medium-sized vessels. Progressive understanding of these diseases has allowed researchers and clinicians to start discussing nailfold video capillaroscopy (NVC) as a future tool for many applications in daily practice. Today, NVC plays a well-established and validated role in differentiating primary from secondary Raynaud's phenomenon correlated with scleroderma. Nevertheless, there has not been sufficient attention paid to its real potential in the ANCA-associated vasculitis. In fact, the role of NVC in vasculitis has never been defined and studied in a multicentre and multinational study. In this review, we carried out a literature analysis to identify and synthesise the possible role of capillaroscopy for patients with ANCA-associated vasculitis. METHODS Critical research was performed in the electronic archive (PUBMED, UpToDate, Google Scholar, ResearchGate), supplemented with manual research. We searched in these databases for articles published until November 2023. The following search words were searched in the databases in all possible combinations: capillaroscopy, video capillaroscopy, nailfold-video capillaroscopy, ANCA-associated vasculitis, vasculitis, granulomatosis with polyangiitis, EGPA, and microscopic polyangiitis. RESULTS The search identified 102 unique search results. After the evaluation, eight articles were selected for further study. The literature reported that capillaroscopy investigations documented non-specific abnormalities in 70-80% of AAV patients. Several patients showed neoangiogenesis, capillary loss, microhaemorrhages, and bushy and enlarged capillaries as the most frequent findings. Furthermore, the difference between active phase and non-active phase in AAV patients was clearly discernible. The non-active phase showed similar rates of capillaroscopy alterations compared to the healthy subjects, but the active phase had higher rates in almost all common abnormalities instead. CONCLUSIONS Microvascular nailfold changes, observed in patients affected by vasculitis, may correlate with the outcome of these patients. However, these non-specific abnormalities may help in the diagnosis of vasculitis. As such, new analysis analyses are necessary to confirm our results.
Collapse
Affiliation(s)
- Gianluca Screm
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Lucrezia Mondini
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Paola Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Francesco Salton
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Liliana Trotta
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Mariangela Barbieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Marco Mari
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Nicolò Reccardini
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Rossana Della Porta
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Metka Kodric
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Giulia Bandini
- Department of Experimental and Clinical Medicine, Division of Internal Medicine, University of Florence, Azienda Ospedaliero–Universitaria Careggi (AOUC), 50134 Florence, Italy
| | - Michael Hughes
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
| | - Mattia Bellan
- Department of Translational Medicine, Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- Center for Autoimmune and Allergic Disease (CAAD), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- Azienda Ospedaliero–Universitaria, Maggiore della Carità, 28100 Novara, Italy
| | - Selene Lerda
- Graduate School, University of Milan, 20149 Milan, Italy
| | - Marco Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| | - Barbara Ruaro
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, University of Trieste, Hospital of Cattinara, 34149 Trieste, Italy; (G.S.)
| |
Collapse
|
3
|
Neubauer-Geryk J, Wielicka M, Myśliwiec M, Zorena K, Bieniaszewski L. The Relationship between TNF-a, IL-35, VEGF and Cutaneous Microvascular Dysfunction in Young Patients with Uncomplicated Type 1 Diabetes. Biomedicines 2023; 11:2857. [PMID: 37893230 PMCID: PMC10604652 DOI: 10.3390/biomedicines11102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the relationship between immunological markers and the dysfunction of cutaneous microcirculation in young patients with type 1 diabetes. The study group consisted of 46 young patients with type 1 diabetes and no associated complications. Microvascular function was assessed with the use of nail fold capillaroscopy before and after implementing post-occlusive reactive hyperemia. This evaluation was then repeated after 12 months. Patients were divided into two subgroups according to their baseline median coverage (defined as the ratio of capillary surface area to surface area of the image area), which was established during the initial exam (coverageBASE). Additionally, the levels of several serum biomarkers, including VEGF, TNF-a and IL-35, were assessed at the time of the initial examination. HbA1c levels obtained at baseline and after a 12-month interval were also obtained. Mean HbA1c levels obtained during the first two years of the course of the disease were also analyzed. Patients with coverageBASE below 16.85% were found to have higher levels of VEGF and TNF-α, as well as higher levels of HbA1c during the first two years following diabetes diagnosis. Our results support the hypothesis that the development of diabetic complications is strongly influenced by metabolic memory and an imbalance of pro- and anti-inflammatory cytokines, regardless of achieving adequate glycemic control.
Collapse
Affiliation(s)
- Jolanta Neubauer-Geryk
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
| | - Melanie Wielicka
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Neonatology, Ann Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Małgorzata Myśliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Leszek Bieniaszewski
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland; (M.W.); (L.B.)
| |
Collapse
|
4
|
Sedaghat B, Raeeskarami SR, Tahghighi F, Assari R, Aghaei-Moghadam E, Razavi-Khorasani N, Najafizadeh SR, Ziaee V. The role of nailfold capillaroscopy in pediatric patients with Kawasaki disease. REUMATOLOGIA CLINICA 2023; 19:255-259. [PMID: 37147061 DOI: 10.1016/j.reumae.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/10/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND Nailfold capillaroscopy has been used as a non-invasive diagnostic method for microvasculature evaluation in various rheumatological disorders. The present study aimed to determine the utility of nailfold capillaroscopy in the diagnosis of Kawasaki Disease (KD). METHOD In this case-control study nailfold capillaroscopy was performed in 31 patients with KD and 30 healthy controls. All nailfold images were evaluated for capillary distribution and capillary morphology such as enlargement, tortuosity, and dilatation of the capillaries. RESULT Abnormal capillaroscopic diameter was identified in 21 patients from the KD group and 4 patients in the control group. The most common abnormality in capillary diameter was irregular dilatation in 11 (35.4%) KD patients and in 4 people (13.3%) in the control group. Distortions of the normal capillary architecture was commonly seen in the KD group (n=8). A positive correlation was observed between coronary involvement and abnormal capillaroscopic results (r=.65, P<.03). The sensitivity and specificity of capillaroscopy for the diagnosis of KD were 84.0% (95%CI: 63.9-95.5%) and 72.2% (95%CI: 54.8-85.8%), respectively. The PPV and NPV of capillaroscopy for KD were 67.7% (95%CI: 48.6-83.3) and 86.7% (95% CI: 69.3-96.2), respectively. CONCLUSION Capillary alterations are more common in KD patients compared to control group. Thus, nailfold capillaroscopy can be useful in detecting these alterations. Capillaroscopy is a sensitive test for detecting capillary alternations in KD patients. It could be used as a feasible diagnostic modality for evaluating microvascular damage in KD.
Collapse
Affiliation(s)
- Banafsheh Sedaghat
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed-Reza Raeeskarami
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Rheumatology Society of Iran, Iran
| | - Fatemeh Tahghighi
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Rheumatology Society of Iran, Iran
| | - Raheleh Assari
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Rheumatology Society of Iran, Iran
| | - Ehsan Aghaei-Moghadam
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Razavi-Khorasani
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Rheumatology Society of Iran, Iran; Rheumatology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Reza Najafizadeh
- Rheumatology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Ziaee
- Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran; Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran; Pediatric Rheumatology Society of Iran, Iran; Rheumatology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
5
|
Bergamo S. The diagnosis of Adamantiades-Behçet disease: Clinical features and diagnostic/classification criteria. Front Med (Lausanne) 2022; 9:1098351. [PMID: 36569165 PMCID: PMC9780472 DOI: 10.3389/fmed.2022.1098351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Adamantiades-Behçet's disease (ABD) is a chronic-relapsing multisystemic inflammatory disease with unknown etiology first described by a Greek ophthalmology Benediktos Adamantiades and a Turkish dermatology Hulusi Behçet. Any organ or apparatus may be involved, though more often there is an involvement of oral and genital mucosae as well as ocular lesions, skin features, and vascular findings. Since there is neither laboratory nor radiological pathognomonic test, the diagnosis is basically clinical according to peculiar signs and symptoms of the disease. With the purpose of giving objectivity and homogeneity to the diagnosis, many authors in time introduced a long series of diagnostic and classification criteria for Adamantiades-Behçet's disease. This mini-review provides an overview of published diagnostic/classification criteria.
Collapse
|
6
|
Hussein MA, Ramadan MM, Moneam MAE, Halim HAE, Ghaffar NAE, Fawzy MW. Interleukin 37; a possible marker of arterial stiffness in Behçet's disease. Am J Med Sci 2022; 364:425-432. [PMID: 35469766 DOI: 10.1016/j.amjms.2022.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Interleukin 37 (IL-37) is an anti-inflammatory cytokine previously studied in Behçet's disease (BD) and atherosclerosis. However, little is known about its relation to macro and microcirculations in BD. Previous studies relied mainly on common carotid artery (CCA) intima-media thickness (IMT) and ankle brachial index (ABI) to study atherosclerosis in BD with conflicting results. This study evaluated flow parameters of CCA, ABI and nailfold videocapillaroscopy in relation to serum IL-37 in BD. METHODS Forty BD patients and 30 healthy controls were included. IMT, peak-systolic, end-diastolic velocities, resistivity index of CCA and ABI were measured by duplex ultrasound. Capillary loop, length, diameter and morphology were recorded by nailfold videocapillaroscopy. Serum IL-37 levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS Compared to controls, patients had higher mean CCA IMT (p < 0.0001), resistivity index (p < 0.001) and peak-systolic velocity (p=0.09) and lower mean CCA end-diastolic velocity (p=0.002), capillary loop, length, arterial, venous limbs diameter and serum IL-37 (p < 0.001). Patients with ABI ≥ 1.4 "indicating stiff arteries" had higher serum IL-37 (p < 0.05 on left, p>0.05 right sides). Serum IL-37 correlated negatively with left CCA end-diastolic velocity "denoting atherosclerosis" and positively with left posterior tibial artery ABI and CRP (p < 0.03) "denoting inflammation". Multiple regression analysis showed only association with left CCA end-diastolic velocity. CONCLUSIONS IL-37 may be related to arterial stiffness in BD and could be used as a possible marker of arteriosclerosis in the disease for further investigations. Changes of CCA peak-systolic, end-diastolic velocities, resistivity index and IMT refer to increased atherosclerosis in larger elastic arteries. In smaller muscular "crural" arteries, vasculitis with possible medial disease may be more evident.
Collapse
Affiliation(s)
- Mohamed A Hussein
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt.
| | - Mostafa Mahmoud Ramadan
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | - Manal Abd El Moneam
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | - Hanan Abd El Halim
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| | | | - Mary Wadie Fawzy
- Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Cairo University, Cairo, Egypt
| |
Collapse
|
7
|
Nailfold video capillaroscopy as a useful diagnostic tool in systemic vasculitis. Microvasc Res 2022; 143:104406. [PMID: 35835173 DOI: 10.1016/j.mvr.2022.104406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/10/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nailfold video capillaroscopy (NVC) enables us a direct view of the microvasculature. Only several capillaroscopy studies in adult patients with vasculitis have been reported. AIM To characterize NVC changes in vasculitis. METHODS Vasculitis patients and healthy controls were evaluated by NVC. NVC changes associated with vasculitis were assessed retrospectively in a cohort of 100 patients with Raynaud's phenomenon (RP). RESULTS 17 patients with active vasculitis and 8 patients with vasculitis in remission were compared to 25 age and sex-matched healthy controls. Active vasculitis patients demonstrated higher rates of neoangiogenesis and capillary loss in comparison to other groups. Two novel NVC abnormalities were observed in patients with vasculitis: "Rolling" (slow capillary flow) and "peri-capillary stippling" (PCS), small deposits that may represent capillary leak. PCS was observed exclusively in 5 of 17 patients with active vasculitis. Retrospectively, we were able to detect PCS also in 14 % of 100 patients that were evaluated for RP, of whom 64 % were diagnosed with scleroderma or a related disorder. CONCLUSIONS Patients with active vasculitis demonstrate frequent capillary abnormalities. Although these abnormalities are non-specific, we suggest that their combination may aid the diagnosis of vasculitis. Future studies are needed to validate our findings.
Collapse
|
8
|
Trevisan G, Trevisini S, Bergamo S, DI Meo N, Bonin S, Ruscio M, Marini M, Gaggino A, Urban F, Pascazio L. Adamantiades-Behçet disease: from clinical heterogeneity to diagnosis during the COVID-19 pandemic. Minerva Cardiol Angiol 2022; 70:502-521. [PMID: 35212505 DOI: 10.23736/s2724-5683.21.05847-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adamantiades-Behçet Disease (ABD) is a systemic disease with vasculitis, characterised by recurrent oral aphthosis and ocular, cutaneous, articular, vascular, cardiopulmonary manifestations and it is mainly found in the territories of the antique "silk road. ABD pathogenesis remains unknown although genetic, infectious and environmental factors seem to be implicated in the development of the disease, which is considered an auto-inflammatory condition. COVID-19 infection can present some symptoms, in particular at the level of oral and pulmonary mucosa, which require a differential diagnosis with ABD. Furthermore, the immunological alterations of this disease, and the drugs used for its treatment could influence the infection by COVID-19, and its clinical evolution. Nevertheless, vaccination anti-COVID-19 is recommended in ABD patients. The most commonly used diagnostic criteria for ABD are those established in 2014 by the International Team for the Revision of the International Criteria for BD (ITR-ICBD). Furthermore, criteria for disease severity according to the Overall Damage Index of Behçet's syndrome (BODI) have recently been proposed in order to quantify the severity of the disease as well as the evolution during follow-up. In ABD patients it is mandatory to investigate on the presence of active/latent tuberculosis, because of the common organ involvement, such as eyes and bowel. ABD has a high morbidity and low mortality, sometimes linked to the rupture of an arterial aneurysm and/or neurological complications. This article is based on a general review on ABD ranging from the history of ABD to possible causes and clinical manifestations. A specific section has been dedicated to the COVID-19 pandemic.
Collapse
Affiliation(s)
- Giusto Trevisan
- DSM Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Sara Trevisini
- ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| | - Serena Bergamo
- AULSS 2 Marca Trevigiana, Ospedale Ca' Foncello, Treviso, Italy
| | - Nicola DI Meo
- ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| | - Serena Bonin
- DSM Department of Medical Sciences, University of Trieste, Trieste, Italy -
| | - Maurizio Ruscio
- ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| | | | - Andrea Gaggino
- DSM Department of Medical Sciences, University of Trieste, Trieste, Italy.,ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| | - Flavia Urban
- ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| | - Lorenzo Pascazio
- DSM Department of Medical Sciences, University of Trieste, Trieste, Italy.,ASUGI Azienda Sanitaria Universitaria Integrata Giuliano Isontina, Trieste, Italy
| |
Collapse
|
9
|
Grover C, Jakhar D, Mishra A, Singal A. Nail-fold capillaroscopy for the dermatologists. Indian J Dermatol Venereol Leprol 2021; 88:300-312. [PMID: 34877857 DOI: 10.25259/ijdvl_514_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 03/01/2021] [Indexed: 11/04/2022]
Abstract
Nail fold is one of the most accessible sites for studying changes in the microcirculation in various microangiopathies. The characterization of changes in microvasculature can provide useful clues towards the diagnosis and prognosis of a disease. The diagnostic utility of nail fold capillaroscopy has improved and expanded over the past couple of decades. Beyond connective tissue diseases, it is now explored for its role in various systemic and dermatological diseases. Incorporation of nail-fold capillaroscopy in the diagnostic criteria of systemic sclerosis has generated interest among dermatologists. The current review is aimed at providing knowledge about nail-fold capillaroscopy to dermatologists. For the purpose of review, a PubMed search was done using the keywords "nail fold capillaries" and "nail fold capillaroscopy". All the articles were retrieved and classified into reviews and clinical studies of various types. The final data were then analyzed and presented in a narrative fashion.
Collapse
Affiliation(s)
- Chander Grover
- Department of Dermatology and STD, University College of Medical College and GTB Hospital, New Delhi, India
| | - Deepak Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Arzoo Mishra
- Department of Dermatology and STD, University College of Medical College and GTB Hospital, New Delhi, India
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical College and GTB Hospital, New Delhi, India
| |
Collapse
|
10
|
Demirbaş A, Elmas ÖF, Demirbaş GU, Atasoy M, Türsen Ü, Lotti T. Potential Utility of Oral Mucosal Capillaroscopy as an Indicator of Microvascular Damage in Behçet Disease: A Preliminary Study. Dermatol Pract Concept 2021; 11:e2021116. [PMID: 34631265 DOI: 10.5826/dpc.1104a116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2020] [Indexed: 10/31/2022] Open
Abstract
Introduction Behçet disease (BD) is an auto-inflammatory condition characterized by multisystemic vasculitis. Oral mucosal capillaroscopy is an easy-to-use, repeatable, non-invasive method for evaluating mucosal microvasculature, contributing to the differential diagnosis and prognosis of various acute and chronic inflammatory diseases. Objectives This study aims to characterize and describe the oral labial mucosal capillary findings in patients with BD using handheld dermatoscopy and to investigate the relationship between the capillary findings and the severity of the disease. Methods This cross-sectional study included patients with BD and healthy subjects. Capillaroscopic examination of the oral labial mucosa in each subject was performed by a handheld dermatoscope using polarized light. The clinical severity of BD was evaluated using Krause's Clinical Severity Scoring for BD. Results Sixty patients with BD and 60 healthy subjects were enrolled in the study. The frequencies of irregular capillaries, microhemorrhages, glomerular vessels, megacapillaries, and tortuous vessels were statistically significantly higher in the patient group when compared to the healthy individuals. In addition, a correlation was detected between the oral mucosal capillaroscopic findings and disease duration, severity, and vascular complications. Conclusions Our study is the first to explore the potential role of oral mucosal capillaroscopic examination in patients with BD. Data obtained from this study indicated that oral mucosal capillaroscopy may be a useful tool to demonstrate microvascular damage in patients with BD.
Collapse
Affiliation(s)
| | - Ömer Faruk Elmas
- Department of Dermatology, Kırıkkale University Kırıkkale, Turkey
| | - Gözde Ulutaş Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Mustafa Atasoy
- Health Science University, Kayseri City Hospital, Department of Dermatology, Kayseri, Turkey
| | - Ümit Türsen
- Mersin University, Department of Dermatology, Mersin, Turkey
| | - Torello Lotti
- Department of Dermatology, Guglielmo Marconi University, Rome, Italy
| |
Collapse
|
11
|
Arslan Uku S, Demir B, Cicek D, Inan Yuksel E. Assessment of nail findings in children with atopic dermatitis. Clin Exp Dermatol 2021; 46:1511-1517. [PMID: 34089190 DOI: 10.1111/ced.14783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/13/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous findings are well known in atopic dermatitis (AD), but nail changes have not received as much attention. AIM To determine the clinical and disease-related capillaroscopic findings of nail findings in paediatric patients with AD. METHODS In total, 100 participants aged 2-16 years were sourced from the dermatology outpatient clinic: 50 of these had been diagnosed with AD according to the Hanifin-Rajka criteria, and the others were 50 healthy controls (HCs) without AD. The AD severity score (SCORing Atopic Dermatitis; SCORAD) was calculated for all patients with AD. A digital epiluminescence device was used for nailfold capillaroscopy. RESULTS The nail findings detected in patients with AD were pitting, punctate leuconychia, trachyonychia, onycholysis and onychomadesis. Pitting was significantly (P < 0.01) more frequent in the patient group (26%) than in the HC group (6%). Similarly, the patient group had significantly higher rates for capillary density decrease (P < 0.01), capillary array irregularity (P < 0.001), capillary dilatation increase (P < 0.001), tortuosity (P = 0.04), ramification increase (P = 0.02), bush-like appearance (P = 0.02) and avascular areas (P < 0.01). Significant correlations were determined between pitting and trachyonychia (P < 0.05, r = 0.21), capillary density decrease (P < 0.05, r = 0.25), avascular areas (P < 0.001; r = 0.29) and SCORAD (P < 0.05, r = 0.35). CONCLUSION The nailfold capillaroscopic images of children with AD were similar to those of scleroderma spectrum disorder. Thus, we believe it would be beneficial to support detailed clinical examination of patients with a capillaroscopic examination.
Collapse
Affiliation(s)
- S Arslan Uku
- Evliya Celebi Training and Research Hospital, Clinics of Dermatology, Kutahya, Turkey
| | - B Demir
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - D Cicek
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| | - E Inan Yuksel
- Department of Dermatology, Firat University Hospital, Elazig, Turkey
| |
Collapse
|
12
|
Akdoğan A, Erden A, Fırat Şentürk E, Kılıç L, Sarı A, Armağan B, Karadağ Ö, Kiraz S. Capillaroscopic findings in Turkish Takayasu arteritis patients. Turk J Med Sci 2019; 49:1303-1307. [PMID: 31648432 PMCID: PMC7018322 DOI: 10.3906/sag-1812-223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/11/2019] [Indexed: 12/11/2022] Open
Abstract
Background/aim Abnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet’s disease, Henoch–Schönlein purpura, and Wegener’s granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA). Materials and methods We studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds. Results The median capillary density of TA patients was 9 (range: 9–11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04). Conclusion Capillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process.
Collapse
Affiliation(s)
- Ali Akdoğan
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Abdulsamet Erden
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esra Fırat Şentürk
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Kılıç
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper Sarı
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Berkan Armağan
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ömer Karadağ
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sedat Kiraz
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
13
|
Kayser C, Bredemeier M, Caleiro MT, Capobianco K, Fernandes TM, de Araújo Fontenele SM, Freire E, Lonzetti L, Miossi R, Sekiyama J, de Souza Müller C. Position article and guidelines 2018 recommendations of the Brazilian Society of Rheumatology for the indication, interpretation and performance of nailfold capillaroscopy. Adv Rheumatol 2019; 59:5. [PMID: 30670098 DOI: 10.1186/s42358-018-0046-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
Nailfold capillaroscopy (NFC) is a reproducible, simple, low-cost, and safe imaging technique used for morphological analysis of nail bed capillaries. It is considered to be extremely useful for the investigation of Raynaud's phenomenon and for the early diagnosis of systemic sclerosis (SSc). The capillaroscopic pattern typically associated with SSc, scleroderma ("SD") pattern, is characterized by dilated capillaries, microhemorrhages, avascular areas and/or capillary loss, and distortion of the capillary architecture. The aim of these recommendations is to provide orientation regarding the relevance of NFC, and to establish a consensus on the indications, nomenclature, the interpretation of NFC findings and the technical equipments that should be used. These recommendations were formulated based on a systematic literature review of studies included in the database MEDLINE (PubMed) without any time restriction.
Collapse
Affiliation(s)
- Cristiane Kayser
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu 740, 3° andar, São Paulo, SP, 04023-062, Brazil.
| | - Markus Bredemeier
- Rheumatology Service, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
| | - Maria Teresa Caleiro
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Karina Capobianco
- Rheumatology Service, Moinhos de Vento Hospital, Porto Alegre, Brazil
| | | | | | - Eutilia Freire
- Rheumatology Service, Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Lilian Lonzetti
- Rheumatology Service, Complexo Hospitalar da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Renata Miossi
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Juliana Sekiyama
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Carolina de Souza Müller
- Rheumatology Division, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| |
Collapse
|
14
|
Bertolazzi C, Gallegos-Nava S, Villarreal-Treviño AV, Alfaro-Rodriguez A, Clavijo-Cornejo D, Gutierrez M. The current role of capillaroscopy in vasculitides. Clin Rheumatol 2019; 38:2299-2307. [DOI: 10.1007/s10067-018-4399-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/03/2018] [Accepted: 12/09/2018] [Indexed: 12/16/2022]
|
15
|
Chen X, Yao X, Chi Y, Guo C, Zhang J, Li J, Zhang S, Rong X, Pasquale LR, Yang L. A Cross-Sectional Observational Study of Nailfold Capillary Morphology in Uveitis. Curr Eye Res 2018; 43:1342-1350. [PMID: 29966450 DOI: 10.1080/02713683.2018.1496265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE We performed nailfold capillary microscopy to explore microvasculature abnormalities in uveitis overall and uveitis stratified in various ways. METHODS This was a cross-sectional, case-control, observational study. One hundred and seven uveitis patients and 130 control subjects were included. We used a JH-1004 capillaroscope to perform nailfold capillary video microscopy on the fourth and fifth digits of each subject's nondominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 25 µm, and avascular zones > 200 µm. Univariate analyses were used for the assessment of case-control morphological differences and multivariate analyses were performed to assess the relation between nailfold capillaroscopic findings and uveitis subgroups. RESULTS In univariate analysis, uveitis patients were more likely to have higher tortuosity ratings and reduced capillary density compared to controls (p < 0.001 for both); furthermore, dilated capillary loops, avascular zone and hemorrhages were more frequent in uveitis versus control subjects (p < 0.001 for all). Among cases, every unit increase in capillary density (vessels/mm) was associated with active uveitis (n = 72 cases) versus inactive disease (n = 35 cases; odds ratio (OR) = 1.7; (95% confidence interval (CI), 1.2-2.5) in multivariate analysis. Furthermore, the presence of any nailfold hemorrhage versus the absence of hemorrhage was more likely to be associated with posterior and panuveitis (n = 41 cases combined) compared to anterior and intermediate uveitis (n = 66 cases combined; OR = 5.8; 95% CI, 2.3-14.2). Moreover, we found a positive correlation between peripheral retinal leakage and nailfold capillaries dilation (r = 0.33; p = 0.015) that was not strictly significant based on the number of comparisons made. CONCLUSIONS Our study provides support for non-ocular capillary bed abnormalities in uveitis, with interesting correlations based on disease stage and anatomical classification.
Collapse
Affiliation(s)
- Xuling Chen
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Xuyang Yao
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Ying Chi
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Chunying Guo
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Jing Zhang
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Jun Li
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Shijie Zhang
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Xin Rong
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| | - Louis R Pasquale
- b Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School , Boston , Massachusetts , USA.,c Channing Division of Network Medicine, Department of Medicine , Brigham & Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
| | - Liu Yang
- a Department of Ophthalmology , Peking University First Hospital , Beijing , China
| |
Collapse
|
16
|
|
17
|
Jammal M, Kettaneh A, Cabane J, Tiev K, Toledano C. [Periungueal capillaroscopy: an easy and reliable method to evaluate all microcirculation diseases]. Rev Med Interne 2015; 36:603-12. [PMID: 25890839 DOI: 10.1016/j.revmed.2015.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/24/2014] [Accepted: 03/13/2015] [Indexed: 10/23/2022]
Abstract
Periungueal capillaroscopy is a simple and reliable non-invasive technique allowing evaluation of cutaneous microcirculation. It was promoted for decades in patients with Raynaud's phenomenon in order to differentiate between the benign primary Raynaud's phenomenon and the secondary form in connective tissue diseases, especially systemic sclerosis. Nevertheless, the value of this procedure has also been shown in numerous pathologies such as diabetes or cardiovascular diseases. This literature review points to the versatility of this useful exam and its results in a large spectrum of diseases with microvascular involvement.
Collapse
Affiliation(s)
- M Jammal
- Service de médecine interne, Hôtel Dieu de France, Beyrouth, Liban.
| | - A Kettaneh
- Service de médecine interne, hôpital privé de Vitry, 94400 Paris, France
| | - J Cabane
- Service de médecine interne, hôpital Saint-Antoine, 94400 Paris, France
| | - K Tiev
- Service de médecine interne, hôpital privé de Vitry, 94400 Paris, France
| | - C Toledano
- Service de médecine interne, hôpital privé de Vitry, 94400 Paris, France
| |
Collapse
|
18
|
Aytekin S, Yuksel EP, Aydin F, Senturk N, Ozden MG, Canturk T, Turanli AY. Nailfold capillaroscopy in Behçet disease, performed using videodermoscopy. Clin Exp Dermatol 2014; 39:443-7. [DOI: 10.1111/ced.12343] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2014] [Indexed: 12/19/2022]
Affiliation(s)
- S. Aytekin
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - E. P. Yuksel
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - F. Aydin
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - N. Senturk
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - M. G. Ozden
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - T. Canturk
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| | - A. Y. Turanli
- Department of Dermatology; Faculty of Medicine; Ondokuz Mayis University; Samsun Turkey
| |
Collapse
|
19
|
Affiliation(s)
- Müzeyyen Gönül
- Second Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | | |
Collapse
|
20
|
Histopathological Evaluation of Behçet's Disease and Identification of New Skin Lesions. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2012:209316. [PMID: 22028988 PMCID: PMC3199096 DOI: 10.1155/2012/209316] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 08/16/2011] [Indexed: 12/30/2022]
Abstract
Behçet's disease (BD) is a multisystemic, relapsing inflammatory disorder with an obscure etiology and pathogenesis. Diagnosis depends on the clinician's ability to identify a group of nonspecific mucocutaneous lesions, which also manifest in a number of other diseases. In recent years, there has been an increase in the studies focusing on the histopathological aspects of Behçet's disease diagnostic mucocutaneous lesions. Their results emphasize the value of histopathology and direct immunofluorescence (DIF) in the differential diagnosis of Behçet's disease.
Collapse
|
21
|
Davatchi F, Shahram F, Chams-Davatchi C, Shams H, Nadji A, Akhlaghi M, Faezi T, Sadeghi Abdollahi B. How to deal with Behcet’s disease in daily practice. Int J Rheum Dis 2010; 13:105-16. [PMID: 20536594 DOI: 10.1111/j.1756-185x.2010.01462.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Fereydoun Davatchi
- Rheumatology Research Center, Medical Sciences/University of Tehran, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|