Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
Use of nailfold capillaroscopy for evaluation of disease activity in juvenile dermatomyositis: Results of a two-center retrospective study
Vera Podzolkova, Ilia S Avrusin, Maria Nikolaeva, Elena Afonina, Siuzanna Davtian, Asel Nurseitova, Kira Kravtsova, Aleksandra Malahova, Alexandr A Yakovlev, Sergey L Avrusin, Olga V Kalashnikova, Vyacheslav G Chasnyk, Mikhail M Kostik
Vera Podzolkova, Department of Children’s Diseases, N.F. Filatov Clinical Institute of Children’s Health, Sechenovskiy University, Moscow 119991, Moskva, Russia
Ilia S Avrusin, Asel Nurseitova, Kira Kravtsova, Aleksandra Malahova, Alexandr A Yakovlev, Sergey L Avrusin, Olga V Kalashnikova, Vyacheslav G Chasnyk, Mikhail M Kostik, Hospital Pediatry, Saint Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia
Maria Nikolaeva, Elena Afonina, Department of Pediatric Rheumatology No. 1, Clinic of Children’s Diseases, Sechenov’s Center of Maternity and Childhood, Sechenovskiy University, Moscow 119991, Moskva, Russia
Siuzanna Davtian, Internal Diseases Faculty, N.V. Sklifosovskiy Institute of Clinical Medicine, Sechenovskiy University, Moscow 119991, Moskva, Russia
Co-first authors: Vera Podzolkova and Ilia S Avrusin.
Author contributions: Podzolkova VA, Avrusin IS, Nikolaeva M, Afonina E, Davtian S, Nurseitova A, Kravtsova K, Malahova A, Yakovlev AA, Avrusin SL, and Kalashnikova OV collected the data; Podzolkova VA, Avrusin IS, and Davtian S performed nailfold capillaroscopy and developed the original draft; Yakovlev AA and Chasnyk VG performed statistical analysis and compiled sections of the manuscript; Kostik MM developed the original draft, provided overall scientific oversight and supervision; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Sechenovskiy University, approval No. 08-25.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Mikhail M Kostik, MD, PhD, Professor, Hospital Pediatry, Saint Pe
tersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg 194100, Russia.
kost-mikhail@yandex.ru
Received: September 16, 2025
Revised: November 6, 2025
Accepted: January 14, 2026
Published online: June 9, 2026
Processing time: 239 Days and 14.9 Hours
BACKGROUND
Juvenile dermatomyositis (JDM) is a rare, immune-mediated children disease that affects both skeletal muscles and skin. Inflammatory vasculopathy is a key part of the JDM pathogenesis. Nailfold capillaroscopy (NFC) is a non-invasive method for microvasculature assessment. Despite the pathogenic relevance of microangiopathy in JDM, the diagnostic utility of NFC in JDM remains insufficiently defined.
AIM
To quantitatively assess capillaroscopic dynamics and their association with clinical and laboratory activity markers in JDM.
METHODS
This retrospective double-center cohort study included 52 children with confirmed JDM, who were followed at the clinics of Sechenov University and Saint Petersburg State Pediatric Medical University. Patients were divided into active and inactive JDM groups based on the modified disease activity score. Demographic, clinical, laboratory, and instrumental data were analyzed. NFC evaluation was performed using standardized criteria developed initially for adult patients with systemic sclerosis and Raynaud’s phenomenon. Statistical analysis was conducted using Windows v.13 (StatSoft).
RESULTS
Active and inactive JDM groups were demographically comparable (predominantly female, median onset age 6 years). NFC revealed marked differences: Active patients showed higher rates of reduced capillary density (96.2% vs 60.9%, P = 0.003), giant capillaries (73.1% vs 13.0%, P < 0.001), perivascular edema (73.1% vs 17.4%, P < 0.001), and greater maximal apical loop width. Disease activity positively correlated with giant capillaries (r = 0.65), perivascular edema (r = 0.60), and reduced capillary density (r = 0.46). These findings confirm that specific NFC features are strongly associated with clinical disease activity, as measured by the disease activity score.
CONCLUSION
Children with active JDM demonstrated more frequent NFC changes, indicating that NFC may play a potential role in monitoring disease activity. Further studies are needed to determine the diagnostic accuracy and prognostic relevance of this approach.
Core Tip: This study demonstrates that specific nailfold capillaroscopy (NFC) abnormalities - notably giant capillaries, perivascular edema, and severely reduced capillary density - are strongly correlated with clinical disease activity in juvenile dermatomyositis. We quantitatively prove that these NFC features are significantly more prevalent in active juvenile dermatomyositis, positioning NFC as a valuable, non-invasive tool for monitoring microvascular damage and assessing disease activity in children, extending its traditional use to scleroderma spectrum disorders.
