Comment on: Prevalence, distribution and associations of the scleroderma capillaroscopic patterns: new insights from the Italian SPRING-SIR registry

Dear Editor, We read with great interest the manuscript by De Angelis et al. in which the authors reported on nailfold videocapillaroscopy (NVC) patterns in a large cohort of 1689 SSc patients [1]. Historically, NVC changes in SSc were described as ‘early’, ‘active’ and ‘late’ patterns as surrogates of disease duration [2]. Interestingly, although De Angelis et al. did find that the prevalence of ‘early’ and ‘active’ SSc patterns decreased progressively with disease duration (defined as the time from the onset of the first non-Raynaud symptom) and that the ‘late’ pattern increased, all three patterns could nevertheless be observed at any stage of the disease. In their study, the ‘early’ pattern was present in 14% of SSc subjects with disease duration >10 years, and the ‘late’ pattern was observed in 10% of SSc patients with a duration