Unveiling the Power of Nailfold Dermoscopy: Staging Raynaud’s Phenomenon: Case Control Research; [Tırnak Kıvrımı Dermoskopisinin Gücünü Ortaya Çıkarmak: Raynaud Fenomenini Evreleme: Olgu Kontrol Araştırması]
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2024
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Abstract
Objective: Raynaud’s phenomenon (RP) is a condition characterized by vasoconstrictive attacks, and it can be diagnosed using nail-fold dermoscopy or videocapilloscopy. This study aimed to investigate the differences in nail-fold dermoscopy between patients with RP and a control group. Material and Methods: The study included 42 patients with RP and 33 individuals in the control group. Dermoscopic and clinical photographs of each finger nailfold were taken, resulting in 750 images that were categorized into 4 groups based on modified Maricq criteria: normal, suspect-capillary dilatation, abnormal-giant capillaries-hemorrhages, and unclassified. To assess the consistency of the staging, 40 random photographs were shown to 69 dermatologists who were asked to provide a rating. Results: The patient group had an underlying disease in 27 patients and the RF in these patients were evaluated as secondary RP. The nail-fold dermoscopy stages were categorized as follows: 31% stage 2, 28.6% stage 3, 28.6% stage 1, and 11.9% stage 4. The inter-observer reliability analysis was 69.56%, and the intra-observer reliability was 75.36%, with Cohen kappa >41. The study found that nail-fold dermoscopy has both inter-observer and intra-observer reliability, and it can be used for the detection of capillary abnormalities, even with minimal training. Therefore, it can be a useful technique in the early diagnosis of concomitant diseases in patients with RP. Conclusion: One notable aspect of this study was the use of a descriptive, simple ordinal score of severity to grade the overall capillaroscopic appearance. Overall, the widespread use of nail-fold dermoscopy in the diagnosis of Raynaud’s phenomenon can be a useful tool for early detection of concomitant diseases. © 2024 by Türkiye Klinikleri.