Analyzing Sarcoidosis via Nailfold Capillaroscopy: Microvascular Insights

Introduction: Sarcoidosis is a systemic granulomatous inflammatory disorder characterized by the formation of non-caseating granulomas that can affect virtually any organ, with a notable predilection for the pulmonary system (1). The disease may also exhibit vasculitic features (2). Microvascular alterations in sarcoidosis can be effectively assessed through nailfold videocapillaroscopy (NVC), a non-invasive imaging technique widely employed in the diagnosis and management of various connective tissue diseases, including systemic sclerosis (2). This approach offers valuable insights into the microvascular involvement associated with sarcoidosis and may enhance our understanding of its pathophysiology and clinical progression. Objects: The objective of our study was to characterize microcirculatory alterations in individuals with sarcoidosis and to investigate their potential association with specific organ involvement. Methods: We performed a retrospective case-control study at a multi-center, including: 55 individuals diagnosed with sarcoidosis and 55 healthy controls. The groups were matched in terms of age and sex distribution. All participants underwent nailfold videocapillaroscopy (NVC) to evaluate microvascular alterations. For all subjects involved in the study, clinical information was collected. All participants met the inclusion criteria: age >18 years and having no comorbidities that could interfere with the results. Results: When sex and age where included as covariates on the logistic model, for the sarcoidosis and healthy subjects group, statistical significant results were found with regard to reduced density (p<0.001), presence of angiogenesis (p<0.001) (Table 1). Microcirculation abnormalities and statistical analysis between sarcoidosis, SA, and healthy population, HS). Conclusions: Our findings corroborate the presence of some microvascular abnormalities in patients with sarcoidosis, highlighting the complexity of vascular involvement in this condition. While these capillaroscopic alterations are observable, their specificity to sarcoidosis remains uncertain, underscoring the need for further research to determine whether these microvascular changes can serve as reliable diagnostic markers. The identification of distinct capillaroscopic patterns that are unique to sarcoidosis would significantly enhance early diagnosis and disease monitoring. Currently, ongoing studies are focused on evaluating the potential utility of nailfold videocapillaroscopy (NVC) as a non-invasive diagnostic tool, as well as exploring its correlation with various clinical manifestations, disease activity, and severity. These investigations aim to clarify whether specific microvascular features can predict disease progression or response to therapy, ultimately contributing to more personalized management strategies for patients with sarcoidosis.