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Journal of Immunology Research
Volume 2015, Article ID 371960, 7 pages
Research Article

Uniphasic Blanching of the Fingers, Abnormal Capillaroscopy in Nonsymptomatic Digits, and Autoantibodies: Expanding Options to Increase the Level of Suspicion of Connective Tissue Diseases beyond the Classification of Raynaud’s Phenomenon

1Department of Clinical Science & Community Health, University of Milano, 20122 Milan, Italy
2Division of Rheumatology, Istituto Gaetano Pini, 20122 Milan, Italy
3Medical Statistics and Biometry, 20122 Milan, Italy
4Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milano, 20122 Milan, Italy
5Rheumatology Unit, Ospedale Moriggia-Pelascini, 22015 Gravedona, Italy

Received 19 February 2015; Revised 2 May 2015; Accepted 4 May 2015

Academic Editor: Clelia M. Riera

Copyright © 2015 Francesca Ingegnoli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In patients with Raynaud’s phenomenon (RP), the role of medical history, capillaroscopy, and autoantibodies in order to provide an early diagnosis of connective tissue disease (CTD) were examined. 115 consecutive adults with uni-, bi-, or triphasic colour changes of the fingers were studied. RP was bilateral in 92.7% of patients. The middle finger was significantly more affected. A lack of association between fingers affected by RP and fingers with capillary abnormalities was observed (0.34–1.66). RP with the cyanotic phase had a higher risk at capillaroscopy to have hemorrhages (1.50–13.30) and giant capillaries (1.48–417.44). The thumb and triphasic involvement have an OR of 1.477 and 1.845, respectively. RP secondary to systemic sclerosis (SSc) had greater value of VAS pain (). The presence of anti-centromere antibodies was significantly associated with a higher risk of SSc (). 44.3% of subjects had uniphasic blanching of the fingers, and among these, 27% was diagnosed as having an overt or suspected CTD. Markers of a potential development of CTDs include severe RP symptoms, positive autoantibodies, and capillary abnormalities. These data support the proposal to not discharge patients with uniphasic blanching of the fingers to avoid missing the opportunity of an early diagnosis.