Bağ dokusu hastalıklarında tırnak kıvrımı kapiller yapısının dermatoskop ile değerlendirilmesi
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Dosyalar
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı; bağ dokusu hastalıklarındaki tırnak kıvrımı kapiller anormalliklerini, videodermatokop kullanılarak ×20, ×30 ve ×40 büyütmelerde değerlendirmekti. Metot: Bu çalışma farklı bağ dokusu hastalıkları olan 72 hasta ve 33 sağlıklı kontrol içermekteydi. 18 hasta primer RyF'ne, 14'ü SLE'e, 12'si RA'a, 14'ü SSk'e, 7'si primer SS'e ve 7'si UCTD'e sahipti. Genişlemiş kapiller, avasküler alanlar, torsiyone-kıvrılmış kapiller, ramifiye-çalı benzeri kapiller ve hemorajiler videodermatoskop kullanılarak ×20, ×30 ve ×40 büyütmelerde değerlendirildi. Daha önce tariflendiği gibi SSkP, bu parametrelerden iki veya daha fazlasının en az tırnık kıvrımında olması şeklinde tanımlandı. Ek olarak torsiyone-kıvrılmış kapiller hariç tutularak, revize-SSkP aynı yolla tanımlandı. Bulgular: Hastaların altmış biri RyF'ne sahipti, bunların 43'de sekonder RyF'ne sahipti. SSkP %78.57 sensitivite, %96.97 spesifite gösterdi. RAlı olguların %25, primer SSli olguların %42.9'u ve UCTDlı olguların %57.1'i SSkP'ni gösterdi. Fakat primer RyFli ve SLEli olguların hiçbiri aynı paterni sergilemedi. Revize-SSkP %64.29 sensitivite, %100 spesifite gösterdi. Primer SSli olguların %28.6'sı ve UCTDlı olguların %42.9'u revize-SSkP'ni gösterdi. Fakat primer RyFli, SLEli ve RAlı olguların hiçbiri aynı paterni sergilemedi. Sağlıklı kontrollerden bir tanesi (%3) SSkP'ni gösterdi ama hiçbiri revize-SSkP'ni göstermedi. Hastalar ve sağlıklı kontroller kıyaslandığında, iki grup arasında torsiyone-kıvrılmış kapillerin saptanmasında anlamlı fark gözlemlenmedi (p>0.05). Ancak kalan dört parametrenin saptanmasında anlamlı fark vardı (p<0.05). Ek olarak ×30 ve ×40 büyütmeler kıyaslandığında, iki büyütme arasında anlamlı fark yoktu (p>0.05). Fakat ×20 ve ×40 büyütmeler kıyaslandığında, torsiyone-kıvrılmış kapillerin saptanmasında anlamlı fark gözlemlendi (p<0.05). Sonuçlar: Bulgular gösterdi ki; tırnak kıvrımı kapillerinin değerlendirmesinde videodermatoskop güvenilir ve kullanışlı bir alet. videodermatoskop uygulaması ×30 veya üzeri büyütmelerde daha uygun. tırnak kıvrımı kapiller incelemesi primer ve sekonder RyF ayrımında kullanılabilir. SSkP yüksek sensitivite ve spesifite oranlarına sahip. SSkP tariflenirken torsiyone-kıvrılmış kapillerin hariç tutulması, sensitivite oranını düşürüyor ancak spesifite oranını arttırıyor.
Objective: The purpose of this study was to assess the nailfold capillary abnormalities in connective tissue diseases by using videodermatoscope at magnifications of ×20, ×30 and ×40. Methods: The study included seventy-two consecutive patients with different connective tissue diseases and thirty-three healthy controls. 18 patients had primer Raynaud phenomenon (RP), 14 had systemic lupus erythematosus (SLE), 12 had rheumatoid arthritis (RA), 14 had systemic sclerosis (SSc), 7 had Sjögren's syndrome (SS) and 7 had undifferentiated connective tissue disease (UCTD). Enlarged capillaries, avascular areas, tortuous-twisted capillaries, ramified-bushy like capillaries and haemorrhages were evaluated by using videodermatoscope at magnifications of ×20, ×30 and ×40. The presence of two or more these parameters in at least two nailfolds was defined as scleroderma pattern (SScP) which was identified previously. Also excluding tortuous-twisted capillaries, the revised-SScP was defined again with the same way. Results: Sixty-one of patients had RP and 43 of them had seconder RP. The SScP exhibited a sensitivity of 78.57% and a specificity of 96.97%. 25% of cases with RA, 42.9% of cases with primer SS and 57.1% of UCTD showed the SScP. But none of the cases with primer RP and SLE exhibited the same pattern. The revised-SScP exhibited a sensitivity of 64.29% and a specificity of 100%. 28.6% of cases with primer SS and 42.9% of UCTD showed the revised-SScP. But none of the cases with primer RP, SLE and RA exhibited the same pattern. One (3%) of the healty controls showed the SScP but none of them showed revised-SScP. No statistically significant difference was observed (p>0.05), when comparing the patients and healthy controls in terms of determining tortuous-twisted capillaries. However, there was a statistically significant difference to determine the remaining four parameters (p<0.05). Also when comparing magnifications of ×30 and ×40, there was not a significant difference (p>0.05). But when comparing magnifications of ×20 and ×40, a significant difference was observed when determining tortuous-twisted capillaries (p<0.05). Conclusions: The results showed that; videodermatoscope is a reliable and useful tool for evaluating the nailfold capillaries. videodermatoscope application is more suitable at magnifications of ×30 or more fold. the nailfold capillaries examination can be use to differantiate the primer RP and seconder RP. SScP has high sensitivity and specifity rate excluding tortuous-twisted capillaries when the defining SScP, decreases sensitivity rate but increases specifity rate.
Objective: The purpose of this study was to assess the nailfold capillary abnormalities in connective tissue diseases by using videodermatoscope at magnifications of ×20, ×30 and ×40. Methods: The study included seventy-two consecutive patients with different connective tissue diseases and thirty-three healthy controls. 18 patients had primer Raynaud phenomenon (RP), 14 had systemic lupus erythematosus (SLE), 12 had rheumatoid arthritis (RA), 14 had systemic sclerosis (SSc), 7 had Sjögren's syndrome (SS) and 7 had undifferentiated connective tissue disease (UCTD). Enlarged capillaries, avascular areas, tortuous-twisted capillaries, ramified-bushy like capillaries and haemorrhages were evaluated by using videodermatoscope at magnifications of ×20, ×30 and ×40. The presence of two or more these parameters in at least two nailfolds was defined as scleroderma pattern (SScP) which was identified previously. Also excluding tortuous-twisted capillaries, the revised-SScP was defined again with the same way. Results: Sixty-one of patients had RP and 43 of them had seconder RP. The SScP exhibited a sensitivity of 78.57% and a specificity of 96.97%. 25% of cases with RA, 42.9% of cases with primer SS and 57.1% of UCTD showed the SScP. But none of the cases with primer RP and SLE exhibited the same pattern. The revised-SScP exhibited a sensitivity of 64.29% and a specificity of 100%. 28.6% of cases with primer SS and 42.9% of UCTD showed the revised-SScP. But none of the cases with primer RP, SLE and RA exhibited the same pattern. One (3%) of the healty controls showed the SScP but none of them showed revised-SScP. No statistically significant difference was observed (p>0.05), when comparing the patients and healthy controls in terms of determining tortuous-twisted capillaries. However, there was a statistically significant difference to determine the remaining four parameters (p<0.05). Also when comparing magnifications of ×30 and ×40, there was not a significant difference (p>0.05). But when comparing magnifications of ×20 and ×40, a significant difference was observed when determining tortuous-twisted capillaries (p<0.05). Conclusions: The results showed that; videodermatoscope is a reliable and useful tool for evaluating the nailfold capillaries. videodermatoscope application is more suitable at magnifications of ×30 or more fold. the nailfold capillaries examination can be use to differantiate the primer RP and seconder RP. SScP has high sensitivity and specifity rate excluding tortuous-twisted capillaries when the defining SScP, decreases sensitivity rate but increases specifity rate.
Açıklama
Anahtar Kelimeler
Bağ dokusu hastalıkları, Kapilleroskopi, Video dermatoskop, Capillaroscopy, Connective tissue disease, Video dermatoscope
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Doğdu, M. (2015). Bağ dokusu hastalıklarında tırnak kıvrımı kapiller yapısının dermatoskop ile değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
