甲皱襞毛细血管镜在自身免疫性皮肤病中的应用

Nailfold Capilaroscopy in Autoimmune Diseases with Skin Involvement

皮肤镜是一种利用偏振光原理、非侵袭性的观察皮表至真皮乳头层结构的辅助工具,当观察甲皱襞微循环时,可称为“甲皱襞皮肤镜”或“甲皱襞毛细血管镜”。在硬皮病(SSc)及继发性雷诺现象等为代表的自身免疫性皮肤病中,甲皱襞毛细血管镜下可见:扩张毛细血管、巨大毛细血管、出血点、毛细血管密度减少及新生毛细血管等“硬皮病模式”改变。该检查的定性及半定量检测方式对硬皮病及其他自身免疫性皮肤病的诊断及预后具有重要意义。

Dermoscopy is a non-invasive diagnostic tool to visualize the structures from the skin surface to the dermal papillary with polarized light.It is named nailfold dermoscopy or nailfold capillaroscopy in the examination of nailfold distal capillaries.In autoimmune diseases with skin involvement,especially systematic sclerosis(SSc)and the secondary Raynaud's phenomenon,the major morphological changes in“SSc pattern”are the enlarged capillaries,giant capillaries,micro-hemorrhages,capillary loss and neo-angiogenesis.The qualified and semi-qualified scoring system for nailfold capillaroscopy to detect changes in the peripheral microcirculation is available and recommended in the diagnosis and prognosis of SSc and other autoimmune diseases.