**3.2 Ophthalmoscope and dermatoscope**

These portable instruments provide images with lower magnification and quality. They are best utilized as bedside evaluation tools for the clinicians. Despite their lower cost, they lack the image storing and processing capabilities.

**191**

*Nailfold Capillaroscopy in Rheumatic Diseases DOI: http://dx.doi.org/10.5772/intechopen.92786*

**3.3 Microscope**

*videocapillaroscope.*

**Figure 2.**

**3.4 Nailfold videocapillaroscope (NFVC)**

cost and loss of panoramic view of the nailfold.

**4. Procedure of nailfold capillaroscopy**

procedure.

15–20 min.

tissue perfusion due to the following testing conditions:

ii.He/she should be explained about the procedure.

iv.The skin to be examined is cleaned using soap and water.

It usually combines optical microscope and digital video camera connected to a computer (**Figure 2b**). It's a handheld, inexpensive tool for the evaluation of capillary parameters. The instrument can be used in varying magnifications from 200× to 600×. In view of its portability and low cost, its best suited to the busy outpatient settings.

*Various instruments used in nail fold capillaroscopy; (a) stereomicroscope, (b) microscope and (c) nail fold* 

This technique provides high magnification (200× to 600×) and, with the aid of specific software, allows a precise measurement of capillaroscopic parameters (capillary length, width, and density) (**Figure 2c**). The disadvantages include high

The procedure followed for nailfold examination is similar for all of the abovementioned instruments. The underlying principle is to minimize the variability in

iii.He/she is allowed to get acclimatized to room temperature for about

i.Patient is instructed to avoid smoking and caffeine for at least 6 h prior to the

v.Then a drop of skin-friendly oils such as cedarwood oil, olive oil, peanut oil, etc. should be placed on the nailfold and observed under NFC. It should be

#### **Figure 2.**

*Vascular Biology - Selection of Mechanisms and Clinical Applications*

Usually there are one to three capillaries in each dermal papilla [3]. Hence most of the examination of the capillaries is concentrated on this region. Each capillary loop consists of an arterial and a venous limb with the latter being wider (**Figure 1**). With the help of various instruments, we are able to visualize the column of blood within these capillaries. The density and morphology of these loops help in the diagnosis and follow-up of patients with rheumatic diseases. We shall address these

The instruments utilized for the study of nailfold capillaries have evolved over time, from stereomicroscope to the high magnification nailfold video capillaroscopy

It is the original technique utilized by Maricq et al. [1] and employs about 20× magnification for the evaluation of capillaries. It provides the panoramic view of nailfold capillaries and makes possible for the assessment of qualitative and quantitative parameters (**Figure 2a**). However, the instrument is expensive and non-

These portable instruments provide images with lower magnification and quality. They are best utilized as bedside evaluation tools for the clinicians. Despite their

in the below mentioned sections.

*Schematic representation of a capillary loop.*

**3.1 Wide-field stereomicroscope**

**3.2 Ophthalmoscope and dermatoscope**

**3. Instruments used in capillaroscopy**

portable, and access is limited to special interest groups.

lower cost, they lack the image storing and processing capabilities.

**190**

(NVC).

**Figure 1.**

*Various instruments used in nail fold capillaroscopy; (a) stereomicroscope, (b) microscope and (c) nail fold videocapillaroscope.*
