Title:Nailfold Capillaroscopy of Fingers and Toes - Variations of Normal
VOLUME: 14 ISSUE: 1
Author(s):Sevdalina Nikolova Lambova* and Ulf Muller-Ladner
Affiliation:Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim, Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Bad Nauheim
Keywords:Nailfold capillaroscopy, healthy subjects, fingers, toes, capillaroscopic examination, capillaroscopic parameters.
Abstract:Background: Nailfold capillaroscopy is the only method for morphological assessment
of nutritive capillaries. The literature data about capillaroscopic findings in healthy individuals are
scarce.
Objective: To evaluate and compare the capillaroscopic findings of fingers and toes in healthy subjects.
Materials and Methods: 22 healthy individuals were included in the study. Capillaroscopic examination
was performed with videocapillaroscope Videocap 3.0 (DS Medica). Exclusion criteria were
as follows: history of vasospasm, presence of accompanying diseases, taking any medications, arterial
hypertension in first degree relatives, overweight or obesity (body mass index > 25kg/m2) and
presence of chronic arterial or venous insufficiency.
Results: Poor visibility of nailfold capillaries was found significantly more frequently in the toes
(22.7%, 5/22) as compared with fingers (0/22). Slight irregularities in capillary distribution and orientation
to their parallel axis were significantly more common in the toes (31.8%, 7/22) as compared
with fingers (9%, 2/22), (p<0.05). The mean diameter of the arterial (0.012±0.002mm) and
the venous limb (0.017±0.002mm) of the toes did not differ significantly as compared to the respective
parameters in the fingers (0.013±0.002mm for the arterial limb, p=0.46 and 0.018±0.002mm
for the venous limb, p=0.25). The mean capillary density also did not differ significantly in the fingers
and toes. The mean capillary length of the toes (0.165±0.096mm) was shorter as compared
with hands (0.220±0.079mm), but the difference was not statistically significant (p=0.37). Presence
of tortuous capillaries (>10%) was found significantly more often in the toes (12/22) as compared
with fingers (6/22, χ2=6.769, p<0.05). Short capillary loops (length<100µm) were observed significantly
more often in the toes (11/22 – toes, 1/22 - fingers, χ2=14.666, p<0.05).
Conclusion: Capillaroscopic examination of the toes shows some differences as compared to those
of the fingers such as greater number of cases with poor visibility and slight irregularities of distribution,
greater number of shorter capillaries and increased tortuosity, which might be related to the
thicker epidermis of the toes and increased capillary pressure due to gravity. The values of the major
capillaroscopic parameters such as capillary diameters and capillary density in fingers and toes
do not differ significantly.
