Beyond rheumatoid nodules in rheumatoid arthritis.

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2024-07-01 DOI:10.63032/VLZL5564
Maria João Cadório, João Teixeira, João Oliveira, Tânia Santiago, Margaria Gonçalo, Cátia Duarte
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引用次数: 0

Abstract

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease predominantly affecting synovial joints. Extra-articular manifestations, including skin involvement, can also occur. The most frequent cutaneous manifestation in RA patients is rheumatoid nodules, occurring in 20-30% of seropositive individuals. These nodules are typically firm, painless, and located on pressure points such as the hands and elbows. However, in a minority of cases, other skin conditions can complicate RA, notably palisaded neutrophilic granulomatous dermatitis (PNGD). PNGD presents as erythematous papules or plaques, often pruritic and distributed symmetrically over extensor surfaces, making it challenging to differentiate from rheumatoid nodules. Histopathological examination is crucial to establish the diagnosis. High clinical suspicion and appropriate referral to Dermatology are essential for accurate diagnosis and management. Treatment of PNGD is focused on underlying disease control. Other options include topical, intralesional or systemic corticosteroids, dapsone or hydroxychloroquine. Herein, we present the case of a 71-year-old woman with RA who developed PNGD, highlighting the importance of a multidisciplinary approach for achieving a favorable clinical outcome.

类风湿性关节炎的类风湿结节之外。
类风湿性关节炎(RA)是一种慢性全身性自身免疫疾病,主要影响滑膜关节。也可出现关节外表现,包括皮肤受累。RA 患者最常见的皮肤表现是类风湿结节,20%-30% 的血清反应阳性者会出现类风湿结节。这些结节通常坚实、无痛,位于手部和肘部等受压点。然而,在少数病例中,其他皮肤病也会并发类风湿关节炎,尤其是嗜中性肉芽肿性皮炎(PNGD)。PNGD表现为红斑丘疹或斑块,常伴有瘙痒,对称分布于伸肌表面,因此很难与类风湿结节相鉴别。组织病理学检查是确诊的关键。高度的临床怀疑和适当的皮肤科转诊对于准确诊断和治疗至关重要。治疗 PNGD 的重点是控制潜在疾病。其他选择包括局部、鞘内或全身使用皮质类固醇激素、达泊松或羟氯喹。在此,我们介绍了一名 71 岁女性 RA 患者的病例,她患上了 PNGD,突出了多学科方法对取得良好临床效果的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
1.20
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