Nailfold Videocapillaroscopic Findings in Children with Atopic Dermatitis

Abstract

Objective: Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder characterized by skin barrier dysfunction and immune dysregulation. This study aimed to compare nailfold videocapillaroscopic findings between children with AD and healthy controls and to explore associations with disease severity and allergic comorbidities. Materials and Methods: In this single-center, controlled, cross-sectional study, 25 children with AD and 25 healthy controls underwent nailfold videocapil-laroscopic examination. Capillary density, arrangement, dilatation, cross capillaries, tortuosity, abnormal vessels, and microhemorrhages were assessed. A composite capillaroscopy score reflected overall videocapillaroscopic abnormalities. In the AD group, disease severity was evaluated using SCORAD, while allergic comorbidities, including asthma, allergic rhinitis, and food allergy, were recorded. Results: The median ages were 7 years in the AD group and 10 years in the control group (p=0.081). Among children with AD, 36% had mild and 64% had moderate eczema. Allergic comorbidities were significantly more prevalent in the AD group, including asthma (8%), allergic rhinitis (32%), and food allergy (28%) (all p≤0.004). Videocapillaroscopic analysis showed that cross capillaries (60% vs. 12%; p=0.001) and capillary tortuosity (28% vs. 4%; p=0.049) were more frequent in healthy controls. No significant differences were observed in capillary density, apical loop width, or overall abnormality rates (p>0.05). Conclusion: Children with AD do not exhibit significant pathological nailfold videocapillaroscopic changes compared with healthy controls. The higher frequency of cross capillaries and tortuosity observed in the control group suggests that these findings are not specific to atopic dermatitis. Further studies with larger cohorts are needed to better evaluate the clinical significance of these observations in atopic dermatitis.