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Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern

Name: Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern
Creator: Gela Gunashvili
Published: 2026-06-15

Diffuse Systemic Sclerosis (anti-Scl-70+)Active Cutolo Scleroderma PatternSevere

Images & measurements38

A 19-year-old man with diffuse systemic sclerosis, positive anti-Scl-70 antibodies, and established active microangiopathy.

AuthorGela Gunashvili

Added to Capillaroscopy.comJune 15, 2026

Clinical context

The case includes a 10-year history of acrocyanosis with tingling and burning sensations, more pronounced in cold environments. He has mild esophageal dysmotility and several apical subpleural fibrous nodules on chest CT, without current indirect echocardiographic signs of pulmonary hypertension. He is currently being treated with mycophenolate mofetil and amlodipine.

Capillaroscopy

Capillaroscopy shows marked capillary reduction (5.86/mm), frequent dilations (54%), a high prevalence of giant capillaries (39.7%), and hemorrhages, without avascular areas, matching an active Cutolo pattern. The CSURI index has increased. Blood flow is homogeneous, with reduced linear velocity.

Key Capillaroscopic Findings

Marked capillary loss (5.86/mm)
High frequency of giant capillaries (39.7%)
Frequent capillary dilations (54%)
Hemorrhages indicating persistent vascular damage
No avascular areas

Atlas images from this case

Anti-Scl-70 systemic sclerosis: enlarged loops and hemorrhages

Anti-Scl-70 systemic sclerosis: enlarged loops and hemorrhages

The study, field by field

Images & measurements

Explore the fields from each finger and open any image for a closer look. Measurements describe the complete examination at each visit.

Contributed by Gela Gunashvili for educational publication on Capillaroscopy.com. For reuse permissions, contact the rights holder.

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Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern

Recorded measurements

Capillary density: 5.86capillaries/mm
Enlarged capillaries: 53.97%
Giant capillaries: 39.68%
Hemorrhages: 0.80/mm

Values from the saved analysis: density and hemorrhages per total analyzed length; percentages of the total capillary count. These are not measurements of an individual image and may differ from averages across fields.

Left index finger

3 images

Nailfold capillaroscopy: left index finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left index finger, field b.

Nailfold capillaroscopy: left index finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left index finger, field c.

Left middle finger

5 images

Nailfold capillaroscopy: left middle finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left middle finger, field b.

Nailfold capillaroscopy: left middle finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left middle finger, field c.

Nailfold capillaroscopy: left middle finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left middle finger, field d.

Left ring finger

6 images

Nailfold capillaroscopy: left ring finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left ring finger, field b.

Field C
Enlarged loops and dark hemorrhagic deposits in the anti-Scl-70-positive active-pattern case. The source report notes no avascular areas in the study.
Read the atlas commentary

Nailfold capillaroscopy: left ring finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left ring finger, field d.

Left little finger

4 images

Nailfold capillaroscopy: left little finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left little finger, field b.

Nailfold capillaroscopy: left little finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left little finger, field c.

Nailfold capillaroscopy: left little finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left little finger, field d.

Right index finger

6 images

Nailfold capillaroscopy: right index finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right index finger, field b.

Nailfold capillaroscopy: right index finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right index finger, field c.

Nailfold capillaroscopy: right index finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right index finger, field d.

Right middle finger

5 images

Nailfold capillaroscopy: right middle finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right middle finger, field b.

Nailfold capillaroscopy: right middle finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right middle finger, field c.

Nailfold capillaroscopy: right middle finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right middle finger, field d.

Right ring finger

5 images

Nailfold capillaroscopy: right ring finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right ring finger, field b.

Nailfold capillaroscopy: right ring finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right ring finger, field c.

Nailfold capillaroscopy: right ring finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right ring finger, field d.

Right little finger

4 images

Nailfold capillaroscopy: right little finger, field b. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right little finger, field b.

Nailfold capillaroscopy: right little finger, field c. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right little finger, field c.

Nailfold capillaroscopy: right little finger, field d. Diffuse Systemic Sclerosis (Anti-Scl-70+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right little finger, field d.

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