A window into the vascular endothelium in COVID-19: Nails

A window into the vascular endothelium in COVID-19: Nails

Authors

  • Ozge Sevil Karstarli Bakay Pamukkale University Faculty of Medicine, Department of Dermatology, Denizli, Turkey
  • Niyazi Cetin Pamukkale University Faculty of Medicine, Department of Dermatology, Denizli, Turkey
  • Umut Bakay Denizli State Hospital, Department of Rheumatology, Denizli, Turkey
  • Gokhan Cinar Agrı Training And Research Hospital, Department of Dermatology, Agrı, Turkey
  • Sule Goksin Pamukkale University Faculty of Medicine, Department of Dermatology, Denizli, Turkey

Keywords:

Proximal nailfold dermoscopy, COVID-19, Capillaroscopy

Abstract

Introduction: Endothelial damage is associated with acute and long-term Coronavirus disease 2019 (COVID-19) complications. Proximal nailfold capillaries are windows for monitoring important microvascular changes associated with endothelial dysfunction.

Objective: We aimed to use dermoscopy to examine the proximal nailfold capillaries of COVID-19 patients and identify microvascular changes.

Methods: A prospective study was designed to evaluate the dermoscopic features of proximal nail fold capillaries in mild to moderate COVID-19 patients and healthy controls between June 2022 and December 2023. The patients underwent their initial dermoscopic examination 2 weeks after the onset of symptoms, followed by a follow-up evaluation 10-14 months later.

Results: The study included 46 patients with mild-to-moderate COVID-19 and 62 healthy controls. The presence of avascular areas (P<0.001), meandering capillaries (P=0.016), microhemorrhages (P=0.007), and enlarged capillaries (p=0.009) in the proximal nail fold is significantly higher in COVID-19 patients than in healthy controls The capillary architecture was disorganized (P=0.002) and density reduced (P<0.001) in COVID-19 patients compared to healthy controls. In the follow-up examination, microvascular changes were observed to regress.

Conclusions: Proximal nailfold dermoscopy is an effective, low-cost, and easily accessible method that enables observing microvascular changes in COVID-19 patients.

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Published

2025-01-29

How to Cite

1.
Karstarli Bakay OS, Cetin N, Bakay U, Cinar G, Goksin S. A window into the vascular endothelium in COVID-19: Nails. Dermatol Pract Concept. 2025;15(1):4927. doi:10.5826/dpc.1501a4927

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