223 Evaluation of nailfold capillaries in dermatomyositis using a dermatoscope

Nailfold capillary (NC) abnormalities are increasingly utilized in the evaluation of rheumatic conditions. Their presence can distinguish primary Raynaud’s phenomenon from secondary etiologies and used diagnostic criteria scleroderma. Dermoscopy is a convenient method evaluating NC changes with similar efficacy to capillaroscopy. We imaged all ten nailfolds subjects dermatomyositis (DM) using dermatoscope smartphone adapter. Fingernails were cleaned an alcohol swab prior evaluation. Images assessed for loop dilation (LD), abnormal morphology (AM), bed disorganization (CBD), hemorrhage (CH), dropout (CD), decreased density (DCD), subpapillary plexus visibility (SP). Cutaneous Dermatomyositis Area Severity activity (CDASI-A) scores systemic (lung, muscle, or joint involvement) collected. Analysis Student’s t-test chi-square test. Subjects hypertension, hyperlipidemia, diabetes, glaucoma, other disease excluded. 44 subjects, 17 amyopathic DM (ADM), included. Mean (standard error) CDASI damage 13 (1.05) 4 (0.39), respectively. 89% demonstrated abnormalities. LD (77%), followed by CBD (73%), two most common findings. often found on 4th 5th fingers. Thumbs fewest CDASI-A was higher patients AM (CDASI 16 vs 10, p=0.003), CD (15 p=0.016), DCD (17 p<0.001), trended towards significance CBD. There trend percentage CH ADM compared those muscle (no difference CDASI-A). skin limited (n=23) active more (74% 38%, p=0.02; no Given its prevalence, useful DM. AM, CD, may be markers cutaneous activity.