Nailfold capillaroscopy

Abstract

In 1663, Johan Christophorous Kolhaus was the first clinician to use a primitive microscope to observe the small blood vessels surrounding the nails and Giovanni Rasori (1766-1873), using a magnifying glass, first described the close relationship between conjunctival inflammation and the presence of an "inextricable knot of capillary loops" [1]. From the time that Maurice Raynaud (1834-1881) presented his thesis in Paris (1862) on local ischemic damage of the hands, feet, nose, and tongue, the intravital capillary microscopy (or capillaroscopy) became recognized as the best investigation to identify and analyze microvascular involvement, which is the key feature of Raynaud's phenomenon (RP). In 1901, H. Hutchinson was able to distinguish primary from secondary Raynaud's phenomenon, and in 1911, W.P. Lombard showed that, using a microscope after the application of a drop of immersion oil, periungual skin capillaries could be observed better [2, 3]. In 1916, W. Weiss standardized the capillaroscopic technique and was able to take pictures of the capillaries using a primordial camera [4]. Soon thereafter, in 1925, G.E. Brown and P.A. O'Leary used the capillaroscopic analysis to show some of the abnormalities that characterize the involvement of the microvasculature during secondary RP and particularly in systemic sclerosis (SSc) [5].