Objectives The clinical manifestations of dermatomyositis (DM) are diverse, nailfold video-capillaroscopy (NVC) can reflect microangiopathy, a process believed to contribute significantly to the clinical manifestations of DM. We aimed to explore the distinctive alterations and implications of nailfold capillary for evaluating disease progression in individuals with DM. Methods We gathered clinical data from 76 DM patients who underwent NVC in the Affiliated Hospital of Nantong University between September 2017 and September 2022. Additionally, we recruited 26 anti-synthase antibody syndrome (ASS) patients and 33 systemic sclerosis (SSc) patients as controls. Utilizing an unsupervised machine learning method (hierarchical clustering analysis) to categorized patients based on NVC results and compared clinical characteristics and survival outcomes. The follow-up period ended in December 2022. Results Anomalous NVC patterns were detected in 73.7% of the 76 DM patients and manifested as diminished capillary density and abnormal capillary morphology. Patients displaying abnormal NVC findings exhibited a significantly higher prevalence of Raynaud's phenomenon and a greater likelihood of being managed with triple combination therapy. Compared with SSc patients, milder NVC changes were observed in patients with DM; nonetheless, NVC abnormalities were more prominent in DM patients when contrasted with individuals with ASS. Furthermore, the patients were classified into two different clusters according to NVC data. Patients in cluster 1 were more likely to develop interstitial lung disease (ILD). Survival outcomes did not differ significantly between the two clusters. Conclusion DM patients can experience varying degrees of aberrant NVC patterns, which can impact ILD risk and warrant clinical vigilance.

中文翻译：

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甲襞视频毛细血管镜检查在皮肌炎评估中的作用


目的 皮肌炎 （DM） 的临床表现多种多样，甲襞视频毛细血管镜 （NVC） 可反映微血管病，这一过程被认为对 DM 的临床表现有重要影响。我们旨在探讨甲襞毛细血管对评估 DM 个体疾病进展的独特改变和意义。方法 我们收集了 2017 年 9 月至 2022年9月在南通大学附属医院接受 NVC 的 76 例 DM 患者的临床数据。此外，我们招募了 26 例抗合成酶抗体综合征 （ASS） 患者和 33 例系统性硬化症 （SSc） 患者作为对照。利用无监督机器学习方法（分层聚类分析）根据 NVC 结果对患者进行分类，并比较临床特征和生存结果。随访期于 2022 年 12 月结束。结果 76 例 DM 患者中有 73.7% 检测到异常 NVC 模式，表现为毛细血管密度降低和毛细血管形态异常。显示异常 NVC 结果的患者表现出雷诺现象的患病率显着升高，并且接受三联治疗的可能性更大。与 SSc 患者相比，DM 患者观察到更轻微的 NVC 变化;尽管如此，与 ASS 个体相比，DM 患者的 NVC 异常更为突出。此外，根据 NVC 数据将患者分为两个不同的集群。第 1 组患者更易发生间质性肺病 （ILD）。两组患者的生存结局无显著差异。 结论 DM 患者可出现不同程度的异常 NVC 模式，这会影响 ILD 风险，需要临床警惕。