Capillaroscopic Patterns

Comprehensive library of capillaroscopic patterns, structural abnormalities, and diagnostic criteria.

Pattern Recognition

Systematic pattern recognition is fundamental to capillaroscopic interpretation. Each pattern provides diagnostic information about underlying microvascular pathology and can help differentiate between various connective tissue diseases.

The patterns are organized by structural characteristics, severity, and clinical associations. Understanding these patterns and their diagnostic significance is essential for accurate interpretation.

Giant capillaries

Structural
Severity: Moderate to Severe

Capillaries with diameter >50 μm. Key feature of scleroderma spectrum disorders.

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Associated with:

Systemic sclerosis
Mixed connective tissue disease
Dermatomyositis

Hemorrhages

Vascular
Severity: Variable

Hemosiderin deposits indicating previous capillary rupture. Sign of microvascular damage.

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Associated with:

Systemic sclerosis
Trauma
Dermatomyositis

Abnormal Capillary Shapes

Structural
Severity: Variable

Tortuous, meandering, or crossed capillaries deviating from normal hairpin appearance.

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Associated with:

Scleroderma
Raynaud's phenomenon
MCTD

Capillary Loss

Density
Severity: Severe

Reduced capillary density <7 capillaries/mm. Indicates advanced microvascular damage.

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Associated with:

Advanced SSc
Digital ulcers
Pulmonary hypertension

Early Scleroderma Pattern

SSc Pattern
Severity: Early

Few giant capillaries, few microhemorrhages, relatively preserved capillary distribution.

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Associated with:

Early systemic sclerosis

Active Scleroderma Pattern

SSc Pattern
Severity: Active

Frequent giant capillaries, frequent microhemorrhages, moderate capillary loss.

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Associated with:

Progressive systemic sclerosis

Late Scleroderma Pattern

SSc Pattern
Severity: Late

Irregular capillary enlargement, severe capillary loss with avascular areas, neoangiogenesis.

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Associated with:

Advanced SSc
Organ involvement

Non-specific Abnormalities

Other
Severity: Variable

Abnormalities not meeting criteria for scleroderma pattern. May be seen in various conditions.

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Associated with:

Primary Raynaud's
Other CTD
Normal variants

Differential Diagnosis Approach

Primary vs Secondary Raynaud's Phenomenon

Primary: Normal capillary density and morphology, no giant capillaries or hemorrhages.
Secondary: Presence of giant capillaries, hemorrhages, capillary loss, or specific patterns.

Scleroderma Pattern Evolution

Early → Active → Late pattern progression correlates with disease activity and severity. Serial capillaroscopy allows monitoring of disease evolution and treatment response.

Other Connective Tissue Diseases

While scleroderma pattern is highly specific, non-specific abnormalities may be seen in SLE, MCTD, and dermatomyositis. Clinical correlation is essential for accurate diagnosis.