Barth Z, et al. – In this current study, the specialists compared the presence of nailfold capillaroscopy (NFC) abnormalities in patients with medium– to longstanding juvenile dermatomyositis (JDM) with that of controls. They disclosed that after medium to long–term follow–up, JDM patients had decreased nailfold capillary density (NCD) and often neovascular pattern, both were associated with higher disease activity and impaired muscle function. These findings indicated that NFC could be used as a biomarker for disease activity also in longstanding JDM.

Methods

• In this study, 58 JDM patients clinically examined median 16.8 (2–38) years after disease onset were compared with matched controls.
• With NFC, the specialists evaluated nailfold capillary density (NCD), giant capillaries, scleroderma and neovascular pattern (defined as scleroderma active or late pattern).
• NFC was analyzed blinded to patient/control identity and disease characteristics.
• By validated tools, they measured disease activity and damage.
• According to the PRINTO criteria, Patients were divided into active and inactive disease.

Results

• Compared to controls, patients had decreased NCD, mean 6.4/mm (2.1) vs 7.6/mm (0.8), (p=0.001); and showed more abnormalities in all other NFC parameters; 36% of patients vs. 4% of controls had NCD<6/mm, (p <0.001).
• As per the outcomes, giant capillaries, scleroderma and neovascular pattern were found in 9%, 84% and 41% of patients, respectively.
• Patients with active disease (n=30) presented more frequently neovascular pattern than inactive patients (n=28) (p =0.041).
• Results revealed that decreased NCD and neovascular pattern were associated with higher disease activity and impaired muscle function.