{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:58:23Z","timestamp":1785513503100,"version":"3.56.0"},"reference-count":25,"publisher":"Mattioli1885","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Nail fold capillaroscopy is a noninvasive tool for assessing early capillary changes in proximal nail fold capillaries in autoimmune connective tissue diseases. Handheld dermatoscopes have expanded its clinical application. Objectives: To characterize nail fold capillary patterns using dermatoscopy and evaluate their association with autoimmune connective tissue disease severity in patients with skin of color (Fitzpatrick skin types IV, V and VI). Methods: A six-month cross-sectional study was conducted at Ghurki Trust Teaching Hospital in Lahore, Pakistan. Ninety-six patients with Fitzpatrick skin types IV-VI and autoimmune connective tissue diseases underwent dermatoscopic evaluation (HEINE DELTA 30 Dermatoscope) and clinical assessment of disease activity. Results: Most participants were female (84.4%). The diagnoses included rheumatoid arthritis (RA) (51%), systemic lupus erythematosus (SLE) (27%), systemic scleroderma (SSc) (17%), and dermatomyositis (DM) (5%). Capillary patterns varied significantly with disease duration (p = 0.001) and diagnosis. Normal patterns were observed in 27 patients (28.1%), nonspecific patterns in 28 patients (29.2%), and scleroderma patterns in 41 patients (42.7%). Scleroderma patterns were most frequent in those with SSC and SLE. Focal microhemorrhages (52.1%) and areas of discrete devascularization (50%) were the most prevalent microvascular findings. Capillary patterns were significantly associated with disease severity (p\u00a0&lt; 0.001). Conclusions: Dermatoscopic assessment of nail fold capillaries may provide a valuable, noninvasive biomarker of disease activity in autoimmune connective tissue diseases. This study provides valuable data on skin of color, which remains underrepresented in dermatological research.<\/jats:p>","DOI":"10.5826\/dpc.1603a6840","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:08:04Z","timestamp":1785510484000},"page":"6840","source":"Crossref","is-referenced-by-count":0,"title":["Dermatoscopic Assessment of Nail Fold Capillary Patterns in Patients of Color with Different Autoimmune Connective Tissue Diseases"],"prefix":"10.5826","volume":"16","author":[{"given":"Eman","family":"Ayesha","sequence":"first","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumera","family":"Hanif","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Tchack","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA\/Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA\/Rao Dermatology, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Didzbalis","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elisabetta","family":"Greco","sequence":"additional","affiliation":[{"name":"Rao Dermatology, New York, NY, USA\/Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, University of Rome, \"Sapienza\", Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talat","family":"Akbar","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliza","family":"Hashim","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Shaukat","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooryia","family":"Shafiq Butt","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Musolff","sequence":"additional","affiliation":[{"name":"Rao Dermatology, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babar","family":"Rao","sequence":"additional","affiliation":[{"name":"Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Somerset, NJ, USA\/Rao Dermatology, New York, NY, USA\/Department of Dermatology, Weill Cornell Medicine, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Nabi","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College\/Ghurki Trust Teaching Hospital, Lahore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27750","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"10.5826\/dpc.1603a6840_ref1","unstructured":"Madhusudan S, Sannidhi K, Amrutha A, Ashwini P, Nikita B. Clinical and Dermatoscopic Characteristics of Nail and Nailfold Capillary Changes in Autoimmune Connective Tissue Disorders. J Cardiovasc Dis Res. 2023;14(9):1167-1172. DOI: 10.48047\/jcdr.2023.14.09.190"},{"key":"10.5826\/dpc.1603a6840_ref2","doi-asserted-by":"crossref","unstructured":"Missoum H, Alami M, Bachir F, et al. Prevalence of autoimmune diseases and clinical significance of autoantibody profile: Data from National Institute of Hygiene in Rabat, Morocco. Hum Immunol. 2019;80(7):523-532. DOI:10.1016\/j.humimm.2019.02.012","DOI":"10.1016\/j.humimm.2019.02.012"},{"key":"10.5826\/dpc.1603a6840_ref3","doi-asserted-by":"crossref","unstructured":"Jakhar D, Grover C, Singal A. Nailfold capillaroscopy with USB dermatoscope: A cross-sectional study in healthy adults. Indian J Dermatol Venereol Leprol. 2020;86(1):33-38. 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