QJM, Vol 90, Issue 8 525-529, Copyright © 1997 by Oxford University Press
RC Littleford, F Khan, MO Hindley, M Ho and JJ Belch
In vivo nailfold capillary microscopy was performed on 10 men with
vibration white finger (VWF) and 10 age-matched male controls. The observed
nailfold capillaries required adaptation of Maricq's classifications and
addition of new morphological scoring systems. These new classifications
produced numerical scores for assessing capillary: dropout, tortuosity,
elongation, visualization of subpapillary venular plexus, and the degree of
disarrangement of nailfold capillary polarity. Application of these new
scores showed, for the first time, a complex pattern of abnormal-nailfold
capillaries in patients with VWF. Capillary dropout was evident in 7/10
patients, with an associated disarrangement in nailfold capillary polarity
in five. All 10 controls had normal capillary morphology. Tortuosity of the
capillary loops and elongation of their length was observed in 30% of
patients. These significant morphological alterations seen in VWF suggest a
local small-vessel vasculitis.
ORIGINAL PAPERS
Microvascular abnormalities in patients with vibration white finger
University Department of Medicine, Ninewells Hospital and Medical School, Dundee, UK.
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