Capillaroscopy findings: visual atlas
Definitions, real images, measurement and common mistakes for capillaroscopy findings, linked to complete clinical cases and studies.
Giant capillaries
A giant capillary is a homogeneously enlarged nailfold capillary with an apical diameter of at least 50 μm. It is also called a megacapillary. The shape and calibrated size matter: a loop that merely looks large on a screen is not enough.
Capillary density
Capillary density is the number of capillaries in the distal row per linear millimeter of nailfold. It describes how many loops remain in an assessable segment, rather than how red or crowded the whole photograph looks.
Microhemorrhages
Nailfold microhemorrhages are deposits of extravasated blood seen near capillary loops. They may appear as dark dots, irregular deposits or streaks. Their distribution and the accompanying vascular changes matter more than an isolated dark spot.
Avascular areas
An avascular area is an abnormally wide gap in the distal capillary row, reflecting focal capillary loss when the field is technically assessable. A blank part of a photograph is not automatically an avascular area.
Tortuous capillaries
Tortuous capillaries have winding or crossed limbs rather than a simple hairpin appearance. Tortuosity describes shape; it is not synonymous with capillary enlargement, branching or a scleroderma pattern.
Abnormal shapes and ramifications
Ramified or bushy capillaries have complex branching forms instead of a simple loop. These are described as abnormal capillary shapes and may indicate microvascular remodeling in the appropriate overall pattern.