Detección de cambios vasculares en el fenómeno de Raynaud cuando se utilizan la capilaroscopia y la termografía. Revisión sistemática de la literatura

Introduction: Raynaud's phenomenon (RP) is an exaggerated vascular response to cold or stress that is manifested by changes in skin colour. It can be primary (PR) or secondary (SR). The objective of this systematic review of the literature (SLR) is to describe and analyse the main differences for the detection of vascular changes in RP between capillaroscopy (NC) and infrared thermography (IRT). Methods: An SLR following PRISMA guidelines in the following information sources: Medline, Cochrane, Pubmed, ClinicalKey and ScienceDirect. Inclusion criteria: observational or analytical articles published until September 2020, that included a population with RP (primary or secondary), with concomitant diagnostic evaluation using NC (microscopic or videocapillaroscopy) and IRT. In the construction of the search equations, MeSH terms («Thermography», «Microscopic Angioscopy») and different keywords crossed with different Boolean operators were used. The Joanna Briggs Institute Critical Appraisal tools for use in Systematic Reviews Checklist was used to assess the risk of bias. The SWiM guideline was followed to synthesize and present the results. Results: 1,397 articles were identified, of which, after screening and eligibility, five were included. They included different populations, evaluated with different equipment; two articles in children and three in adults. Predominantly Caucasian and female population, total of 403 individuals (79 minors). The two studies carried out in the paediatric population showed non-concordant results and the studies in the adult population showed similarities in their results (NC better discriminates PR from SR), but with different connective tissue pathologies associated with SR. Discussion: Microvascular findings from two diagnostic tools (NC and IRT) are presented through the SLR when used concomitantly in RP. Through the 5 articles, it is not possible to conclude that there are clear differences or advantages / disadvantages in the preferential use of one of the two diagnostic techniques in RP, highlighting the value of NC for differentiating between PR and SR. Further studies are required to analyse differences between the two techniques.