Differential Diagnosis > Distribution > Acral > Nails > Nail Fold Capillary Microscopy

Nail Fold Capillary Microscopy

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scleroderma

•capillary dilatation and drop out
•seen in systemic sclerosis and CREST but not in morphea nor in idiopathic Raynaud’s  (therefore may permit the differentiation of early scleroderma from idiopathic Raynaud’s)

dermatomyositis

•capillary dilatation and drop out (i.e. changes resemble those of scleroderma)
•Dr. Fisher has "never seen a case of dermatomyositis without these nail fold capillary changes"

sle

•normal density but enlarged, tortuous loops (meandering loops that may resemble glomerular tufts)