Caracterización del patrón capilaroscópico del pliegue ungueal en personas sin enfermedad evidente mediante técnicas de inteligencia artificial. Prueba piloto.

Abstract

INTRODUCTION: ungueal fold capillary microscopy is a non-invasive method in order to evaluate the skin’s microvasculature that contributes to the diagnosis of several autoimmune and vascular disorders. Normal patterns and abnormalities of capillaries are not yet well defined; they remain mostly as subjective measurements. OBJECTIVE: to characterize, through artificial intelligence techniques, the proximal capillary pattern of ungueal fold in adults without an evident disease. METHODS: for this descriptive study, a digital camera attached to a stereo-microscope was used to capture 763 ungueal fold capillary images from 42 subjects. We applied a computerized image process to analyze and obtain quantitative data of capillary length, width, angle (polarity), density and index of capillary turtuosity that was described in terms of mean, standard deviation, maximum and minimum values and 5, 25, 50, 75 y 95 percentiles. RESULTS: most of the morphological characteristics studied yielded a positive asymmetry with the median lower than the average. CONCLUSIONS: this pilot assay constitutes a first attempt to quantitatively characterize capillary bed pattern of subjects without evident disease. This procedure establishes the basis for its application in a larger sample which, in a further step, would allow us to contrast the patterns now found with those of patients with connective tissue diseases, and so, to acquire more objective parameters for the diagnosis of these diseases.

Keywords

Capillaroscopy

capillary microscopy

normal patterns

proximal ungueal fold

artificial intelligence

References

Bergman R, Sharony L, Schapira D, Nahir MA, Balbir-Gurman A. The handheld dematoscope as a nail-fold capillaroscopic instrument. Arch Dermatol. 2003; 139:1027-30.

Houtman PM, Kallemberg CGM, Fidier V, Wonda AA. Diagnostic significance of nailfold capillary patterns in patients with Raynaud’s phenomenon. J Rheum 1986; 13:556-63.

Kimby E, Fagrell B, Bjorkholm M, Holm G, Mellstadt H, Norberg R. Skin capillary abnormalities in patients with Raynaud´s phenomenon. Acta Med Scan. 1984; 215:127-34.

Jaramillo F, Brieva J, Sánchez A. Capilaroscopia. Observaciones en 65 pacientes con desórdenes del tejido conectivo. Acta Med Col. 1988; 13: 129-38.

Maricq HR, LeRoy EC, D`Angelo WA. Diagnostic potential of in vivo capillary microscopy in scleroderma and related disorders. Arthritis Rheum 1980; 23: 183-89.

Bukhari M, Hollis S, Moore T, Jayson MIV, Herrick AL. Quantization of microcirculatory abnormalities in patients with primary raynauds phenomenon and systemic sclerosis by video capillaroscopy. Rheumatology 2000; 39:506-12.

Bukhari M, Herrick AL, Moore T, Manning J, Jayson MIV. Increased nailfold capillary dimensions in primary Reynaud’s phenomenon and systemic sclerosis. Br J. Rheumatol 1996; 35:1127-31.

Lefford F, Edwards JCW. Nailfold capillary microscopy in connective tissue disease: a quantitative morphological analysis. Ann Rheum Disease 1986; 45:741-9.

Kabasakal Y, Elvins DM, Ring EFJ, Mc Hugh NJ. Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls. Ann Rheum Dis. 1996; 55:507-12.

Riaño JC., Prieto FA, Jaramillo F, Sánchez E. Extracción de la Tortuosidad como Característica Morfológica de Imágenes Capilares Usando Dimensión Fractal. In: Congreso CONCIBE- Guadalajara-México; 2006.

Dolezalova P, Young SP, Bacon P A, South Woods TR. Nailfold Capillary Microscopy in Healthy Children and In Childhood Rheumatic Diseases. Ann Rheum Dis. 2003; 62:444-9.

Terreri MTRA, Andrade LEC, Pucinelli ML, Hilario MOE, Goldenberg J. Nailfold capillaroscopy: normal findings in children and adolescents. Semin Arthritis Rheum 1999; 29:36-42.

Herrick AL, Moore T, Hollis S, Jason MIV. The influence of age on nailfold capillary dimensions in childhood. J Rheum 2000; 27:797-811.

Lee P, Leung FV, Alderdice C, Armstrong S K. Nailfold capillary microscopy in the connective tissue diseases: a semiquatitative assessment. J Rheum 1983; 10:930-8.

Maricq HR. Widefield capillary microscopy. Technique and rating scale for abnormalities seen in scleroderma and related disorders. Arthritis Rheum 1981; 24:1159-64.

Maricq HR. Comparison of quantitative and semi quantitative estimates of nailfold capillary abnormalities in scleroderma spectrum disorders. Microvasc Res 1986; 32: 271-6.