Exploring Nailfold Videocapillaroscopy in Children with Psoriatic Arthritis: Are There Any Hidden Vascular Signatures?

Objectives: Juvenile psoriatic arthritis (JPsA), a subtype of juvenile idiopathic arthritis, is a chronic inflammatory disease characterized by joint and skin involvement. Microvascular alterations, including endothelial dysfunction and inflammation, are thought to contribute to its pathophysiology. Nailfold videocapillaroscopy (NVC) is a non-invasive technique for assessing microvascular changes. This study aimed to evaluate NVC findings in children with JPsA compared to healthy controls, investigating its potential diagnostic and monitoring utility.

Methods: This cross-sectional study included 25 children with JPsA and 33 age- and sex-matched healthy controls. NVC was performed on eight fingers per participant, focusing on capillary density, morphology, and the presence of microhemorrhages. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score-27. Statistical analyses compared capillaroscopic findings between groups and explored correlations with clinical parameters.

Results: In JPsA patients, tortuous capillaries (84% versus 24%, p < 0.001), crossed capillaries (100% versus 63.6%, p = 0.001), and microhemorrhages (28% versus 0%, p = 0.002) were significantly more frequent compared to controls. No specific capillaroscopy pattern was detected in the JPsA cohort. Capillary density and apical loop widths did not differ significantly between groups (p = 0.92 and p = 0.93, respectively). Disease duration negatively correlated with capillary density (r = -0.484, p = 0.014), suggesting progressive microvascular changes over time.

Conclusion: Nailfold videocapillaroscopy revealed distinct microvascular abnormalities in children with JPsA, including increased tortuosity and microhemorrhages, highlighting its potential as a diagnostic and monitoring tool. Longitudinal studies with larger cohorts are warranted to validate these findings and clarify the prognostic significance of NVC in JPsA.