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A Portable Digital Microphotography Unit for Rapid Documentation of Periungual Nailfold Capillary Changes in Autoimmune Connective Tissue Diseases
RICHARD D. SONTHEIMER
ABSTRACT. Objective. While employing a DermLite dermoscopy unit to assess pigment pattern networks in melanocytic skin lesions, it was observed that this compact, portable dermoscopy unit can also be used to quickly detect nailfold capillary changes when entertaining a diagnosis of autoimmune connective tissue diseases (CTD) such as dermatomyositis (DM), scleroderma/systemic sclerosis (SSc), or systemic lupus erythematosus. Aware that the suppliers of the DermLite dermoscopy unit also market a portable digital microphotography unit based on the DermLite optical principles for efficiently documenting cutaneous pigment network patterns, we investigated whether this unit (DermLite Foto flash unit attached to a Nikon Coolpix digital camera) might be used to photographically document nailfold capillary changes in patients with autoimmune CTD. Methods. A DermLite Foto flash unit attached to a Nikon Coolpix digital camera was used in a controlled observational study to obtain digital photographs of nailfold capillaries in a small sequential sample of patients with autoimmune CTD attending a rheumatic skin disease subspecialty clinic in an academic department of dermatology. Results. The digital microphotography system proved to be highly useful in documenting the nailfold vascular changes observed in a small sample of patients with DM. We observed that the nailfold capillary changes seen in patients with clinically amyopathic DM were qualitatively and quantitatively similar to those seen in patients with classical DM. Conclusion. Digital microphotography systems designed for examining pigmented skin lesions can be used easily to document nailfold capillary changes often observed in DM and SSc. Nailfold capillary changes documented in this manner appear to be indistinguishable in clinically amyopathic DM and classical DM. (J Rheumatol 2004;31:539-44) Key Indexing Terms:
DERMOSCOPY
From the Department of Dermatology, University of Iowa College of Medicine/University of Iowa Health Care, Iowa City, Iowa, USA. Supported by a departmental endowment from the Herzog Foundation, and the Joseph Marshall Family of Morningside, Iowa. The DermLite Foto flash and digital camera used in this study were supplied without cost by 3Gen, LLC (Dana Point, California, USA). In addition, financial support for the cost of publication of the color photographs in this report was also generously provided by 3Gen, LLC. No other direct financial consideration from 3Gen, LLC was received by the author. R.D. Sontheimer, MD, John S. Strauss Endowed Chair in Dermatology, Professor and Head, Department of Dermatology, University of Iowa College of Medicine/University of Iowa Health Care. Address reprint requests to Dr. R.D. Sontheimer, Department of Dermatology, University of Iowa College of Medicine, 200 Hawkins Dr. 2045BT-1, Iowa City, IA 52242-1090. E-mail: richard-sontheimer@uiowa.edu Submitted April 22, 2003; revision accepted July 25, 2003. |