Differential Diagnosis > Distribution > Acral > Nails > Nail Fold Capillary Microscopy

Nail Fold Capillary Microscopy

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scleroderma

capillary dilatation and drop out
seen in systemic sclerosis and CREST but not in morphea nor in idiopathic Raynauds  (therefore may permit the differentiation of early scleroderma from idiopathic Raynauds)

dermatomyositis

capillary dilatation and drop out (i.e. changes resemble those of scleroderma)
Dr. Fisher has "never seen a case of dermatomyositis without these nail fold capillary changes"

sle

normal density but enlarged, tortuous loops (meandering loops that may resemble glomerular tufts)