Nailfold Capillaroscopic Monitoring as Preventive Medicine in Subjects Exposed to Ionising Radiation

Capillaroscopy consists of in vivo observation of microvessels using special microscopes with a short focal length. Normally, when looking at the nail fold, where capillaroscopy is commonly used, the capillaries are arranged like hairpins, lined up in parallel or obliquely to the field of vision in three or four layers above the subpapillary venous network, approximately 20 loops per mm. Ionising radiation can badly damage the skin and underlying tissues. The capillary network is among the first structures to show an effect. Moderate doses of radiation cause damage endothelial cells with hypertrophy or hyperplasia of endothelial cells, which can block capillaries while having little effect on larger vessels . Occlusion of capillaries impedes blood flow not only in nearby tissue but also in areas farther away. Capillaroscopic examination of the nail fold is irreplaceable in the field of radioprotection especially in cases of exposure of the hands. Nailfold capillaroscopic monitoring lets us observe the degree to which qualitative and quantitative alterations of the capillaries are a function of the evolution of the lesion. Therefore, for biological monitoring of subjects exposed to radiation the authors propose to use this microvascular quantitative analysis of the nailfold region. Experience, matured over many years by our team, highlights the relation between the sum of repeated exposure and the importance of tissue alterations evidenced by microcirculation.