Nailfold Capillaroscopy in Systemic Lupus Erythematosus (SLE): a Point-of-Care Tool That Parallels Disease Activity and Predicts Future Complications

Purpose of ReviewSystemic lupus erythematosus (SLE) is an autoimmune disease characterized by vascular complications, endothelial cell injury with subsequent dysfunction. Nailfold video capillaroscopy (NVC) is a non-invasive and reliable point-of-care method that can be used to directly visualize microscopic digital capillaries and monitor patients. In this review, we will describe NVC’s role in assessing SLE disease activity and prognosticating risk for developing vascular complications.Recent FindingsIn SLE, qualitative NVC changes like the presence of microhemorrhages and enlarged capillaries correlate with disease activity. These abnormalities are also associated with specific autoantibody profiles (e.g., anti-phospholipid and anti-U1-RNP antibodies). Recent studies show NVC changes may increase risks of digital ulceration, pulmonary arterial hypertension, and accelerated cardiovascular disease.SummaryNVC may be used in personalized medicine as an adjunct in assessing SLE activity which may help prognosticate risk of serious complications, but more studies are needed to further delineate its role in specific SLE disease subtypes.