Original papers
Original proposal of capillaroscopic images’ classification in psoriasis vulgaris and psoriatic arthritis

Abstract
Introduction: Nailfold capillaroscopy is a non-invasive, repeatable and well-tolerated method for intravital assessment of skin microcirculation. It is used in the diagnosis of systemic sclerosis as well as in the assessment of the progress of the disease. Numerous diseases resulting from abnormalities in microcirculation are indications for performing capillaroscopic examination. Bearing in mind the presence of obvious microvascular changes in psoriasis, capillaroscopy may become a useful procedure in diagnosing and monitoring the course of the disease.
Aim: The aim of the study was tentative classification of the types of nailfold capillaroscopic patterns in both psoriasis vulgaris and psoriatic arthritis. Material and methods: The study included 53 patients (47.75%) suffering from psoriatic arthritis and 58 patients (52.25%) with psoriasis vulgaris. In the study, an original form for capillaroscopic assessment of the nailfold was used. Capillaroscopic examinations were conducted by means of an optical microscope (type: ProLab, model: MSZ).
Results: Four original types of capillaroscopic patterns were found in psoriatic patients: type I normal or close to normal, in 43.24% of patients; type II included patients with many tortuous capillaries and was found in 32.43% of the studied patients; type III – a “psoriasis plaque” type – in 15.32% of patients, and type IV, characterized by a pale background as well as a decreased number of capillaries and presence of frail and thin capillaries, was observed in 9.01% of patients. A significant correlation between the capillaroscopic pattern and psoriasis arthritis was found (p = 0.005). 18.87% of patients with psoriasis arthritis presented type IV capillaroscopic pattern, which was absent in the patients with no joint involvement.
Conclusions: Capillaroscopic examination may be helpful in the diagnosis of psoriasis, especially psoriatic arthritis, since it allows for visualization of specific (distinct) nailfold capillaries’ patterns.
Key words: capillaroscopy, psoriasis, psoriatic arthritis.