Dermatomyositis (DM) is an immune mediated inflammatory disease classically associated with muscular and cutaneous involvement. Existing studies have suggested characteristic nailfold findings may be observed in DM, indicating a potential role for nailfold microscopic examination in the diagnosis of DM. To that end, we performed a systematic review of literature pertaining to nailfold microscopic, capillaroscopic, and dermoscopic findings observed in patients with DM, with a secondary review of the association of nailfold microscopic findings with myositis-specific antibody (MSA) and myositis-associated antibody (MAA) status. Thirty-seven papers, representing 346 patients, met inclusion criteria. The most prevalent nailfold findings were evidence of increased vascular diameter (64.5%, n = 223) and decreased vascularity (57.5%, n = 199). Scleroderma-spectrum pattern and microhemorrhage or hemorrhage were both observed in 156 (45.1%) patients. Fifty-one patients had nailfold capillaroscopic findings reported in direct association with antibody positivity and demonstrated a range of nailfold findings, preliminarily suggesting associations between antibody-status and capillaroscopic findings. The results of our study align with existing data indicating the scleroderma-spectrum pattern and the pattern's composite features are prevalent in patients with DM. Our review further demonstrates a variety of nailfold capillaroscopic findings are found in patients positive for MSAs and MAAs.
Keywords: Antibodies; Capillaroscopy; Dermatomyositis; Dermoscopy; Nailfold.
© 2024. The Author(s).