Role of short courses on nailfold capillaroscopy in obtaining abilities for the identification of microvasculopathy in patients with Raynaud's phenomenon

Abstract

Introduction: An early distinction between "normal" and "abnormal" capillaroscopic pattern during the first visit to a dermatologist has a crucial significance for a diagnostic management of Raynaud's phenomenon (RP). There exists a question about the level of expertise sufficient to evaluate the microcirculation.

Aim: To evaluate the utility of short courses on NFC among dermatologists and medical students in obtaining sufficient abilities for the identification of microvasculopathy in patients with RP using videocapillaroscope and handheld dermoscope.

Methods: Both groups participated in 1-h course on NFC. Before the course, participants were asked to classify 20 videocapillaroscopic and 10 dermoscopic capillaroscopic pictures into "normal" or "abnormal" pattern. Each picture was displayed on a separate slide MS PowerPoint for 10 s. The evaluation was repeated soon after the course.

Results: A total of 36 dermatologists and 49 medical students were enrolled. The rate of properly classified dermoscopic and videodermoscopic pictures increased after the course in both groups, but students improved the accuracy of classification on dermoscopic pictures to the greater extent than dermatologists. The rate of correctly recognized pictures with "abnormal" pattern was significantly greater than ones with "normal" pattern at the baseline and after the course, independently of imagining tool.

Conclusions: Short courses on NFC may improve the classification of capillaroscopic images, even in medical staff with no previous experience in NFC. The recognition of capillaroscopic abnormalities seems to be easier than obtaining the confidence that evaluated picture has "normal pattern."

Keywords: Raynaud's phenomenon; dermoscopy; microvasculopathy; nailfold capillaroscopy.

FIGURE 1

(A) Normal capillaroscopic pattern seen in videocapillaroscopy (200× magnification); (B) normal capillaroscopic pattern seen in videocapillaroscopy (200× magnification); (C) abnormal capillaroscopic pattern seen in videocapillaroscopy (200× magnification); (D) abnormal capillaroscopic pattern seen in videocapillaroscopy (200× magnification)

FIGURE 2

(A) Normal capillaroscopic pattern seen in dermoscopy (15× magnification enhanced by smartphone); (B) normal capillaroscopic pattern seen in dermoscopy (15× magnification enhanced by smartphone); (C) abnormal capillaroscopic pattern seen in dermoscopy (10× magnification without enhancement by smartphone); (D) abnormal capillaroscopic pattern seen in dermoscopy (20× magnification enhanced by smartphone)