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Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern

Name: Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern
Creator: Gema María Lledó Ibáñez
Published: 2026-02-13

Limited Cutaneous Systemic Sclerosis (ACA+)Active Cutolo Scleroderma PatternSevere

Images & measurements33

A 38-year-old woman with limited cutaneous systemic sclerosis, anti-centromere antibodies, and established active microangiopathy.

AuthorGema María Lledó Ibáñez

Added to Capillaroscopy.comFebruary 13, 2026

Clinical context

This case includes a 5-year history of Raynaud's phenomenon, esophageal dysmotility, and interstitial lung disease with an NSIP pattern, without current indirect echocardiographic signs of pulmonary hypertension.

Capillaroscopy

Capillaroscopy shows marked capillary loss (5.3/mm), frequent dilations, high prevalence of giant capillaries (27.5%), and hemorrhages, matching an active Cutolo pattern.

Key Capillaroscopic Findings

Marked capillary loss (5.3/mm)
High frequency of giant capillaries (27.5%)
Frequent capillary dilations (61.6%) with hemorrhages

Atlas images from this case

ACA-positive systemic sclerosis: overview

ACA-positive systemic sclerosis: overview

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 Gema María Lledó Ibáñez for educational publication on Capillaroscopy.com. For reuse permissions, contact the rights holder.

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Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern

Capillaroscopy shows marked capillary loss (5.3/mm), frequent dilations, high prevalence of giant capillaries (27.5%), and hemorrhages, matching an active Cutolo pattern.

Recorded measurements

Capillary density: 5.33capillaries/mm
Enlarged capillaries: 61.59%
Giant capillaries: 27.48%
Hemorrhages: 0.21/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

4 images

Nailfold capillaroscopy: left index finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left index finger, field b.

Nailfold capillaroscopy: left index finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left index finger, field c.

Nailfold capillaroscopy: left index finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left index finger, field d.

Left middle finger

4 images

Nailfold capillaroscopy: left middle finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left middle finger, field b.

Nailfold capillaroscopy: left middle finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left middle finger, field c.

Nailfold capillaroscopy: left middle finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left middle finger, field d.

Left ring finger

4 images

Nailfold capillaroscopy: left ring finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left ring finger, field b.

Nailfold capillaroscopy: left ring finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left ring finger, field c.

Nailfold capillaroscopy: left ring finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) 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. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: left little finger, field b.

Nailfold capillaroscopy: left little finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: left little finger, field c.

Nailfold capillaroscopy: left little finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: left little finger, field d.

Right index finger

4 images

Nailfold capillaroscopy: right index finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right index finger, field b.

Nailfold capillaroscopy: right index finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right index finger, field c.

Nailfold capillaroscopy: right index finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right index finger, field d.

Right middle finger

4 images

Nailfold capillaroscopy: right middle finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right middle finger, field b.

Nailfold capillaroscopy: right middle finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right middle finger, field c.

Nailfold capillaroscopy: right middle finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) 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. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right ring finger, field b.

Nailfold capillaroscopy: right ring finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right ring finger, field c.

Nailfold capillaroscopy: right ring finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right ring finger, field d.

Overview
Overview of the nailfold in the ACA-positive active-pattern case. The reported density and giant-capillary percentage describe the study, not this photograph alone.
Read the atlas commentary

Right little finger

4 images

Nailfold capillaroscopy: right little finger, field b. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field B
Nailfold capillaroscopy: right little finger, field b.

Nailfold capillaroscopy: right little finger, field c. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field C
Nailfold capillaroscopy: right little finger, field c.

Nailfold capillaroscopy: right little finger, field d. Limited Cutaneous Systemic Sclerosis (ACA+) with Active Cutolo Pattern. — Field D
Nailfold capillaroscopy: right little finger, field d.

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