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Cutolo Active Pattern — SCE Rheumatology MCQ

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HardSystemic SclerosisCutolo Active PatternSCE Rheumatology

A 50-year-old woman with SSc has nailfold capillaroscopy showing frequent giant capillaries and avascular areas. What Cutolo classification stage is this?

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Correct answer: D — Active pattern with frequent giant capillaries, haemorrhages and moderate loss

The best answer is “Active pattern with frequent giant capillaries, haemorrhages and moderate loss”. Cutolo SSc capillaroscopy: Early (few giant capillaries few haemorrhages). Active (frequent giants frequent haemorrhages moderate dropout). Late (severe dropout neoangiogenesis). Active pattern indicates ongoing microvascular damage and may correlate with disease progression. The competing options represent related diagnoses, tests or treatments, but they do not match the decisive phenotype, safety constraint or management point in this stem.

Reference: BSR systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/