Kapillaroscopia

Kapillaroscopia, also called capillaroscopy, is a noninvasive imaging technique used to study the microcirculation by visualizing capillary loops, most commonly at the nailfold. It can be performed with optical capillaroscopy or videocapillaroscopy, using magnifications typically ranging from 20x to 200x. The procedure is simple: after acclimatization to room temperature (often 20–25°C) and removal of nail polish, a drop of immersion oil or glycerin is placed on the nailfold and the capillaries are examined with a microscope or video-based device. Images or videos of multiple digits are recorded for analysis.

Interpreting findings involves assessing capillary morphology, density, and organization. Normal capillaries appear as evenly spaced, hairpin-shaped loops with regular density. Abnormal patterns include dilated giant capillaries, microhemorrhages, capillary dropouts and avascular areas, and overall disorganization of the capillary architecture. Specific patterns are associated with different diseases: for example, a scleroderma pattern features giant capillaries, hemorrhages, and capillary loss, with early, active, and late variants described for systemic sclerosis. Capillaroscopy is also used to evaluate Raynaud phenomenon to distinguish primary from secondary forms and to monitor microvascular involvement in other connective tissue diseases such as dermatomyositis and lupus.

Clinical utility and limitations: Capillaroscopy supports diagnosis, prognosis, and monitoring of treatment response in connective tissue diseases with microvascular involvement. It is noninvasive and repeatable but operator-dependent and requires standardized technique and scoring. Environmental factors such as temperature, humidity, and nail care, as well as patient factors like age and smoking, can affect results. Results should be interpreted within the broader clinical context and other investigations.