Nailfold capillary abnormalities in erectile dysfunction of systemic sclerosis: a EUSTAR group analysis

Rheumatology (Oxford). 2014 Apr;53(4):639-43. doi: 10.1093/rheumatology/ket392. Epub 2013 Dec 5.


Objective: The objective of this study was to analyse an association between nailfold capillary abnormalities and the presence and severity of erectile dysfunction (ED) in men with SSc.

Methods: A cross-sectional analysis of the prospective European League Against Rheumatism (EULAR) Scleroderma Trial and Research database was performed. Men with SSc were included if they had undergone nailfold capillaroscopy and simultaneous ED assessment with the 5-item International Index for Erectile Function (IIEF-5).

Results: Eighty-six men met the inclusion criteria. Eight men (9.3%) had not had sexual intercourse and could not be assigned an IIEF-5 score. Sixty-nine of the 78 men (88.5%) with an IIEF-5 score had nailfold capillary abnormalities, of whom 54 (78.3%) suffered from ED. Nine men (11.5%) had no nailfold capillary abnormalities, of whom six (66.7%) had ED (P = 0.44). ED was more frequent in older men (P = 0.002) and in men with diffuse disease (P = 0.06). Men with abnormal capillaroscopy had a higher median EULAR disease activity than men without (P = 0.02), a lower diffusing capacity of the lung (P = 0.001) and a higher modified Rodnan skin score (P = 0.04), but mean IIEF-5 scores did not differ [15.7 (S.D. 6.2) vs 15.7 (S.D. 6.3)]. IIEF-5 scores did not differ between men with early (n = 12), active (n = 27) or late (n = 27) patterns (IIEF-5 scores of 17.9, 16.3 and 14.7, respectively). There were no differences in the prevalence of early, active and late capillaroscopy patterns between men with or without ED.

Conclusion: Neither the presence or absence of abnormal capillaroscopy findings nor the subdivision into early, active and late patterns is associated with coexistent ED in SSc.

Keywords: ageing; erectile dysfunction; nailfold capillaroscopy; pathogenesis; scleroderma pattern; systemic sclerosis; vasculopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Capillaries / physiopathology*
  • Cross-Sectional Studies
  • Disease Progression
  • Erectile Dysfunction / etiology
  • Erectile Dysfunction / physiopathology*
  • Humans
  • Male
  • Microscopic Angioscopy
  • Middle Aged
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / physiopathology*
  • Severity of Illness Index
  • Skin / blood supply