Capillaroscopy of toes

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Nailfold capillaroscopy of fingers is an important tool for diagnosis and monitoring of collagen-vascular diseases. However, little is known about capillaroscopy of toes.

Patients and methods:

Capillaroscopy of the first and second toe was performed in 50 healthy volunteers and 67 patients with chronic venous insufficiency (n = 22), peripheral arterial diseases (n = 24) and collagen-vascular diseases (n = 21) with a capillaroscope under oil immersion with non-polarized light and 50-fold magnification.


Capillary density of toes (5–9/mm) was reduced compared to fingers (7–11/mm).


In contrast to fingers, capillaries of toes show a higher degree of variability. In addition to the classic parallel hairpin form, one may also find tortuous capillaries, ramifications, elongations and capillary bundles. Little difference was noted between patients with vascular and collagen-vascular diseases as compared to volunteers. More ramifications were observed in peripheral arterial diseases and more capillary bundles were seen in collagen-vascular diseases. Pathological patterns such as megacapillaries, avascular areas and hemorrhages were not seen in toes.


The physiological capillary pattern differs between fingers and toes. The detected pathologic alterations in vascular and collagen-vascular diseases have to be confirmed in further studies.

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