R M Bauersachs1, F Lössner. 1. I Medical Department, University Hospital, Frankfurt/Main, Germany.
Abstract
OBJECTIVES: To evaluate a new method for rapid and efficient assessment of capillary morphology. METHODS: Nailfold capillary morphology in 18 patients with Raynaud's phenomenon was investigated with a new bedside test, based on a modified dermatoscope using a novel gel-immersion technique. These findings were compared with those obtained by standard capillary microscopy. RESULTS: With the standard microscope, six patients had dilated capillaries, six had mega-capillaries, seven had avascular fields, eight had ramified capillaries, six had contorted capillaries, and seven patients showed micro-haemorrhages, respectively. The dermatoscope identified exactly the same patients to have the same capillary abnormalities. One hundred and thirty six fingers were available for pairwise comparison: The kappa statistic was 0.93 for dilated capillaries, 0.97 for mega-capillaries, 0.93 for avascular areas, 0.78 for ramified capillaries, 0.81 for contorted capillaries, and 0.94 for micro-haemorrhages, respectively. The average examination time was 18 (range 8-30) minutes with the standard microscope and 4 (3-8) minutes with the dermatoscope. CONCLUSION: A new diagnostic tool for rapid and efficient examination of nailfold capillaries is described for circumstances when a standard microscope is not available. This study shows that the hand held device can be used in clinical routine with sufficient diagnostic efficacy and little expenditure, both timewise and financially.
OBJECTIVES: To evaluate a new method for rapid and efficient assessment of capillary morphology. METHODS: Nailfold capillary morphology in 18 patients with Raynaud's phenomenon was investigated with a new bedside test, based on a modified dermatoscope using a novel gel-immersion technique. These findings were compared with those obtained by standard capillary microscopy. RESULTS: With the standard microscope, six patients had dilated capillaries, six had mega-capillaries, seven had avascular fields, eight had ramified capillaries, six had contorted capillaries, and seven patients showed micro-haemorrhages, respectively. The dermatoscope identified exactly the same patients to have the same capillary abnormalities. One hundred and thirty six fingers were available for pairwise comparison: The kappa statistic was 0.93 for dilated capillaries, 0.97 for mega-capillaries, 0.93 for avascular areas, 0.78 for ramified capillaries, 0.81 for contorted capillaries, and 0.94 for micro-haemorrhages, respectively. The average examination time was 18 (range 8-30) minutes with the standard microscope and 4 (3-8) minutes with the dermatoscope. CONCLUSION: A new diagnostic tool for rapid and efficient examination of nailfold capillaries is described for circumstances when a standard microscope is not available. This study shows that the hand held device can be used in clinical routine with sufficient diagnostic efficacy and little expenditure, both timewise and financially.