TY - JOUR T1 - Might Nailfold Capillaroscopy Be a “Proxy” for Lung Involvement in Connective Tissue Diseases? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1061 LP - 1063 DO - 10.3899/jrheum.181408 VL - 46 IS - 9 AU - VANESSA SMITH AU - OLIVER DISTLER AU - MAURIZIO CUTOLO Y1 - 2019/09/01 UR - http://www.jrheum.org/content/46/9/1061.abstract N2 - Lung involvement [pulmonary arterial hypertension (PAH)] and/or interstitial lung disease (ILD) are leading causes of death in systemic sclerosis (SSc)1. They also contribute significantly to the morbidity and mortality in other connective tissue diseases (CTD), such as Sjögren syndrome (SS), systemic lupus erythematosus (SLE), undifferentiated connective tissue disease (UCTD), mixed connective tissue disease (MCTD), and rheumatoid arthritis (RA)2,3,4. Even though no cure is available, timely detection of lung involvement and subsequent administration of appropriate therapies may slow its progression. Nevertheless, a large stumbling block lurks in everyday practice concerning early detection of lung involvement in CTD5,6. More specifically, early detection of lung involvement may be hampered by the nonadherence to guidelines or expert consensus recommendations from PAH or ILD experts7,8. For example, the European Society of Cardiology Guidelines suggest screening for PAH in asymptomatic patients with SSc at the initial visit, and expert consensus recommends a high-resolution computed tomography scan (HRCT) at baseline in all patients with SSc to screen for ILD, but a large proportion of the SSc community still does not follow these recommendations in daily clinical practice7,8. There may be many reasons for this. One of them is the belief that it is useful to screen only symptomatic patients. Another reason is a lack of real multidisciplinary clinics to care for patients with rare CTD, making it challenging to do specialized investigations such as echocardiography, right heart catheterization, and HRCT. Efforts are being made by different policy makers to address this nonadherence and nonstandardized care. One example is the European Union, which has funded through its health program the European Reference Networks on rare … Address correspondence to Dr. V. Smith, Department of Internal Medicine, Ghent University; Department of Rheumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium. E-mail: vanessa.smith{at}ugent.be ER -