Egyptian Rheumatologist最新文献

{"title":"Clinicopathological concordance of skin lesions in connective tissue diseases: analysis of skin lesions in 415 patients in a Tertiary Hospital","authors":"Hamad A. Alfahaad ,&nbsp;Hamza S. Alshehri ,&nbsp;Nada A. Almalki ,&nbsp;Maram N. Alosaimi ,&nbsp;Raghad Y. Alasiri ,&nbsp;Fahad A. Al Bahri ,&nbsp;Soliman A. Alsaiari","doi":"10.1016/j.ejr.2025.10.009","DOIUrl":"10.1016/j.ejr.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Dermatological disorders often require histopathological examination of skin biopsies to ensure accurate diagnosis and effective management.</div></div><div><h3>Aim of the work</h3><div>To describe the spectrum of clinical and histopathological diagnoses for skin manifestations presenting in rheumatic diseases(RDs) patients referred for skin biopsy, and to assess the diagnostic accuracy of both.</div></div><div><h3>Patients and methods</h3><div>This retrospective study was conducted at Aseer Central Hospital and included clinical and histopathological diagnoses from 415 skin biopsies extracted from medical records.</div></div><div><h3>Results</h3><div>The mean age of cases was 40.1 ± 17.8 years;230 females and 185 males (F:M 1.24:1), 40(9.6 %) were juvenile. Among 415 skin biopsies, the most common clinical skin diagnosis was psoriasis(12.3 %) followed by discoid lupus erythematosus(DLE)(11.6 %), vasculitis(11.3 %) and morphea(4.3 %). Histopathologically, leucocytoclastic vasculitis was found in 17.3 %, psoriasis in 10.1 %, DLE in 8.7 %, and vasculitis and morphea in 5.1 % each. The most common site for skin biopsy was the lower limbs(41 %) followed by head/neck(24.3 %) and upper limbs(16.63 %). 37.8 % of cases had a matched clinical with histopathological diagnosis. Clinical diagnoses were similar according to gender. For pathological diagnosis, granuloma annulare was found only in females, while keratosis and erythema only in males. In juvenile cases, psoriasis was found in 27.5 % of males vs 8.3 % of females(p = 0.001) and lupus profundus in 7.5 % of males vs 1.3 % of females(p = 0.03), and so were significantly more frequent. A double diagnosis was significantly lower histopathologically(2.4 %) compared to clinical diagnosis (8.2 %)(p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>A clinicopathological gap exists in skin manifestations and biopsy findings in RD patients. Raising the awareness of rheumatologists to this issue is warranted for cutaneous manifestations and histopathological findings.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 50-54"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential effects of essential phospholipid and vitamin B12 in experimentally-induced arthritis in rats","authors":"Sunita Goswami,&nbsp;Ashima Sharma,&nbsp;Smit Agrawal","doi":"10.1016/j.ejr.2025.10.005","DOIUrl":"10.1016/j.ejr.2025.10.005","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate the effects of essential phospholipid (EPL) and vitamin B₁₂ on experimentally-induced arthritis in rats.</div></div><div><h3>Materials and methods</h3><div>The effect of EPL (100 mg/kg, p.o) and vitamin B₁₂ (1.5 mg/kg, i.p) on formaldehyde (acute model for 10 days) and complete Freund’s adjuvant (chronic model for 14 days)-induced arthritis in 66 Wistar rats (180–200 g) of either sex grouped according to the treatment and their combination. The changes in inflammatory conditions were measured in terms of paw volume, arthritic index, complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), total cholesterol, triglyceride, malondialdehyde (MDA) and reduced glutathione. The standard non-steroidal anti-inflammatory drug, indomethacin, was used as a reference drug.</div></div><div><h3>Results</h3><div>The EPL, vitamin B₁₂ and their combination significantly reduced (p &lt; 0.05) the paw volume and arthritic index. Combination of vitamin B₁₂ with EPL significantly normalized the haematological parameters like ESR, white blood cells, red blood cells and platelet counts, packed cell volume, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration as compared to disease control group (<em>p</em> &lt; 0.001). The combination of EPL with vitamin B₁₂ showed the most significant decrease in biochemical parameters like CRP, RF, MDA levels, cholesterol, triglyceride and increase in reduced GSH when compared with the disease control.</div></div><div><h3>Conclusion</h3><div>Both EPL and vitamin B₁₂ and more potentially their combination have a potent anti-arthritic action in both acute and chronic experimentally-induced arthritis models. The mechanism of action of EPL and vitamin B₁₂ can be attributed to anti-inflammatory and antioxidant activity.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 34-38"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scleroderma assessment questionnaire (SAQ) in systemic sclerosis patients: Relation to clinical characteristics and disease severity","authors":"Omima A. El-Farra ,&nbsp;Hazem M. Farrag ,&nbsp;Rasha A. Abdel-Magied","doi":"10.1016/j.ejr.2025.10.002","DOIUrl":"10.1016/j.ejr.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Systemic sclerosis (SSc) is a chronic autoimmune disease with heterogeneous manifestations affecting the skin, lungs, and heart. Patient-Reported Outcomes (PROs) provide critical insights into subjective disease burden, yet their relationship with objective clinical assessments remains underexplored.</div></div><div><h3>Aim of the work</h3><div>To evaluate the association between a PRO measure; the Scleroderma Assessment Questionnaire (SAQ) and physician-assessed disease activity using the European Scleroderma Study Group (EScSG) index among Egyptian patients with SSc.</div></div><div><h3>Patients and methods</h3><div>In a cross-sectional study of 45 adult SSc patients, clinical, pulmonary, and cardiac data were collected, including modified Rodnan skin score (mRSS), high-resolution CT, pulmonary function tests, 6-minute walk test (6MWT), and echocardiography. Associations between SAQ, EScSG, and disease parameters were analyzed.</div></div><div><h3>Results</h3><div>This study included 39 females and 6 males (F:M 6.5:1) with median age of 39 years. 29 patients had limited subtype with median disease duration 7 ± 5 years. 25 patients (55.6 %) were active according to EScSG index with median 3 ± 3. Median SAQ was 0.95 ± 0.88. Both SAQ and EScSG correlated with mRSS (r = 0.55, p &lt; 0.001 and r = 0.46, p &lt; 0.001 respectively), calcinosis (r = 0.47, p = 0.001 and r = 0.44, p &lt; 0.001 respectively) and dysphagia (r = 0.51, p &lt; 0.001 and r = 0.3, p = 0.045 respectively), while exertional dyspnea correlated only with SAQ (r = 0.37, p = 0.02) with strong correlation with the respiratory index (r = 0.63, p = 0.001) in contrary to SAQ (r = 0.19, p = 0.21). There was strong correlation between EScSG and SAQ (r = 0.71, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The SAQ and the physician-assessed disease activity measure provide a synergistic perspective on the disease burden in SSc, enhance patient-centered care and may improve disease monitoring.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 39-43"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anticyclic citrullinated peptide antibody positivity on subclinical cardiovascular profile of patients with established rheumatoid arthritis","authors":"Noha H. Shedid ,&nbsp;Adel M. Ali ,&nbsp;Samah A. El-Bakry ,&nbsp;Riham N. Mohamed ,&nbsp;Maha A. El-Serwy","doi":"10.1016/j.ejr.2025.10.006","DOIUrl":"10.1016/j.ejr.2025.10.006","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate the impact of anti-cyclic citrullinated peptide antibodies (anti-CCP) positivity on subclinical cardiovascular (CV) profile in patients with established rheumatoid arthritis (RA) as demonstrated by echocardiography and carotid ultrasound (US).</div></div><div><h3>Patients and methods</h3><div>This study included 30 RA patients with positive anti-CCP and another 30 RA patients with negative anti-CCP matched for age and gender. The clinical characteristics were recorded and laboratory data including anti-CCP and rheumatoid factor (RF) were measured. The disease activity score (DAS28) was assessed, plain X-ray of both hands was evaluated for joint damage using Larsen score, echocardiography and carotid ultrasound were assessed.</div></div><div><h3>Results</h3><div>The 60 patients were 49 females and 11 males (F:M 4.5:1). The mean age and disease duration (years) of the positive vs negative anti-CCP patients were 45.6±5.8 vs 43.2±10.4, and 13.5±8.1 vs 7.5±4.2, respectively. The anti-CCP positive group had significant longer disease duration, higher Larsen score, RF positivity and titer, abnormal carotid intima-media thickness (CIMT), carotid ultrasound and echocardiographic abnormalities, diastolic dysfunction (all p&lt; 0.001), valve sclerosis/ calcification and overall CV abnormalities (p&lt; 0.001). Anti-CCP was an independent risk factor of CV abnormalities (OR 1.03, 95 %CI 1.002–1.056).</div></div><div><h3>Conclusion</h3><div>Anti-CCP antibody is associated with unfavourable subclinical CV profile in patients with established RA. Subclinical atherosclerosis as determined by abnormal CIMT and subclinical cardiac abnormalities, mainly diastolic dysfunction and valvular sclerosis/calcification on echocardiography, were higher in the patients with positive anti-CCP. Those patients should have early and more periodic screening for CV complications to hinder their progression by planning appropriate treatment strategies.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 28-33"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency and predictors of pulmonary hypertension in patients with sarcoidosis, connective tissue diseases and interstitial lung disease","authors":"Yosri M. Akl,&nbsp;Youssef M. Soliman,&nbsp;Mohamed S. Ismaeil,&nbsp;Ahmed I. Elkomy,&nbsp;Hadeel A. Mohamed","doi":"10.1016/j.ejr.2025.11.004","DOIUrl":"10.1016/j.ejr.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) is the mean of pulmonary arterial pressure (mPAP) ≥ 20 mm Hg at rest as detected by right-sided heart catheterization (RHC). It is classified into 5 grades; grade 3 is associated with hypoxia and interstitial lung diseases (ILDs) such as sarcoidosis, connective tissue diseases (CTD), hypersensitivity pneumonitis (HP) and idiopathic pulmonary fibrosis (IPF).</div></div><div><h3>Aim of the work</h3><div>To estimate the frequency and predictors of pH in sarcoidosis, CTDs, HP and IPF.</div></div><div><h3>Patients and methods</h3><div>The study included 28 patients with sarcoidosis, 21 with CTD-related ILDs, 63 were diagnosed as HP, and 18 patients with IPF. All patients were subjected to clinical examination, high resolution computed tomography (HRCT) chest, arterial blood gases, six-minute walking test, spirometry and echocardiography. RHC was performed and the probability of pH determined.</div></div><div><h3>Results</h3><div>The mean age of all patients was 48.5 ± 12.2 years and the F:M was 4.4:1. There were 85 (65.4 %) patients with low probability for PH, 8 (6.2 %) with intermediate probability and 37 (28.5 %) with high probability. By RHC, PH was 33.8 % in all patients: sarcoidosis 0.7 %, CTD-related ILDs 3 %, IPF 7.7 % and HP in 22.4 %. The residence (p = 0.038), raising birds (p = 0.01), dyspnea duration (p &lt; 0.001), ILD duration (p &lt; 0.001) and desaturation percentage (p &lt; 0.001) are the main predictors of pH in ILD.</div></div><div><h3>Conclusion</h3><div>A third of the patients with ILD had PH most prominent in HP followed by IPF but less in sarcoidosis and CTDs. The residence, raising birds, dyspnea duration, ILD duration and desaturation percentage are the main predictors of pH in ILD.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 90-94"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical expression of axial spondyloarthritis among a cohort of Egyptian patients","authors":"Basma R Sakr ,&nbsp;Kamal El-Garf ,&nbsp;Maha Mousa","doi":"10.1016/j.ejr.2025.08.003","DOIUrl":"10.1016/j.ejr.2025.08.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study characteristics of axial spondyloarthritis (axSpA) among Egyptian patients in relation to disease and gender related features.</div></div><div><h3>Patients and methods</h3><div>This study recruited 88 axSpA patients. Evaluation of demographics, clinical characteristics, laboratory tests, Bath ankylosing spondylitis disease activity index (BASDAI), Axial Spondyloarthritis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), and health index (HI) was performed.</div></div><div><h3>Results</h3><div>Patients with axSpA showed male predominance (M: F 2.3:1), human leucocytic antigen-B27 (HLA-B27) positivity in 59.4 %, high ASDAS in 60.2 %, poor HI in 13.3 %, peripheral manifestations were mainly arthritis, and enthesitis, extra musculoskeletal manifestations were mainly anterior uveitis. Early axSpA was reported in 8 % of patients. Females displayed initial axial and peripheral symptoms (p = 0.019), more arthritis (p = 0.003), dactylitis (p &lt; 0.001), enthesitis (p = 0.042), and family history of SpA (p = 0.022) than males, with comparable BASDAI, ASDAS, BASFI and HI. Patients with radiographic axSpA (r-axSpA) exhibited initial axial symptoms (p &lt; 0.001), male predominance (p = 0.002), higher C-reactive protein (CRP) (p = 0.016), HI (p = 0.007) and HLA-B27 positivity (p = 0.04), while non-radiographic axSpA (nr-axSpA) patients displayed initial axial and peripheral symptoms (p &lt; 0.001), more arthritis (p &lt; 0.001), dactylitis (p &lt; 0.001), enthesitis (p = 0.001), early axSpA (p = 0.001), family history of SpA (p = 0.021), with comparable BASDAI, ASDAS and BASFI.</div></div><div><h3>Conclusion</h3><div>Patients with r-axSpA were predominantly males, with higher CRP, HLA-B27 positivity, initial axial presentation, worse HI, less frequent arthritis, dactylitis and enthesitis, early axSpA, and family history of SpA compared to nr-axSpA. Females displayed more arthritis, dactylitis and enthesitis, initial axial and peripheral symptoms, and family history of SpA compared to males.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 216-220"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic of choice after secukinumab failure in psoriatic arthritis patient: Ixekizumab or interleukin-23 inhibitors – A retrospective study","authors":"P.S. Ong ,&nbsp;P.J. Lee ,&nbsp;C.R. Ng ,&nbsp;Fariz Yahya ,&nbsp;S.S. Chng ,&nbsp;S.A. Maulana","doi":"10.1016/j.ejr.2025.06.003","DOIUrl":"10.1016/j.ejr.2025.06.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>This study aimed to compare the clinical response to ixekizumab versus interleukin-23 inhibitors (IL23i) in psoriatic arthritis (PsA) patients who failed secukinumab treatment.</div></div><div><h3>Patients and methods</h3><div>A retrospective multi-center study included active PsA patients who experienced treatment failure with secukinumab and were subsequently treated with either ixekizumab or IL23i. Baseline demographics, including disease duration<strong>,</strong> domains involved and duration of secukinumab therapy were recorded. The disease activity in PsA (DAPSA) score and body surface area (BSA) were used to assess the effectiveness of the biologics in PsA.</div></div><div><h3>Results</h3><div>The mean age of the 25 patients was 49.4 ± 12.4 years, 15 females and 10 males with secukinumab failure were enrolled. 14 (56 %) patients switched to IL23i and 11 (44 %) to ixekizumab. The median duration of secukinumab exposure was 85.7 ± 56.2 weeks. The primary reason for switching was worsening joint and skin symptoms (52 %). Complete resolution of dactylitis (7/7) and enthesitis (5/5) was achieved with ixekizumab or IL23i. Patients with primary secukinumab failure showed PsA improvements regardless the treatment switch. Multivariate analysis identified comedication with conventional synthetic DMARDs and baseline DAPSA as predictors for achieving treatment targets in the ixekizumab group.</div></div><div><h3>Conclusion</h3><div>This study found that after secukinumab failure, the response to ixekizumab and IL23i was comparable, regardless of the type of therapeutic failure. By comparing these alternatives, it offers valuable insights into the evolving landscape of PsA management. Further prospective studies with larger sample sizes are needed to validate these findings and guide the selection of the optimal biologic therapy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 168-171"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of fibrinogen to albumin ratio in patients with systemic lupus erythematosus: Relation with disease characteristics","authors":"Noha H. Shedid,&nbsp;Hanan M. Farouk,&nbsp;Esraa M. Ahmed,&nbsp;Mohammed M. Mohammed","doi":"10.1016/j.ejr.2025.06.006","DOIUrl":"10.1016/j.ejr.2025.06.006","url":null,"abstract":"<div><h3>Aim of the work</h3><div>to investigate the role of fibrinogen to albumin ratio (FAR) in systemic lupus erythematosus (SLE) patients and its relationship with disease characteristics.</div></div><div><h3>Patients and methods</h3><div>This study included 45 SLE patients with activity and another 45 without as well as 45 controls. The clinical, laboratory data including FAR measurement and SLE disease activity index 2000 (SLEDAI-2K) were assessed.</div></div><div><h3>Results</h3><div>The patients were 83.3% females, with a median (IQR) age of 30.5 (23–41) years and disease duration of 4 (2–7) years. The median FAR value was significantly higher in patients (1.4, 0.6–1.8) compared to control (0.6, 0.5–0.8) and in active (1.6, 1.2–2.1) compared to inactive (0.7, 0.5–1.7) patients (both p&lt; 0.0001). Higher FAR values were significantly associated with receiving disease modifying antirheumatic drugs (DMARDs) (n= 82) (1.4, 0.7–2 vs 0.4, 0.15–1.1) (p= 0.01). FAR significantly correlated with the erythrocyte sedimentation rate (ESR) (r= 0.3, p= 0.004), anti-double stranded deoxyribonucleic acid (anti-dsDNA) (r= 0.28, p= 0.008) and urinary protein/creatinine (r= 0.48, p&lt; 0.0001) while inversely with complement (C3: r= -0.41, p&lt; 0.0001 and C4: r= -0.31, p= 0.003). Anti-dsDNA was the most significant factor affecting the values of FAR (β= 0.24, p= 0.04). The best cut-off value of FAR to discriminate SLE from controls and active from inactive patients were 1.1 and 0.8, with a diagnostic sensitivity of 58.9% and 86.7% and specificity of 95.6% and 55.6%, p&lt; 0001 and p&lt; 0.001, respectively.</div></div><div><h3>Conclusion</h3><div>The FAR was significantly increased in SLE patients and was linked with disease activity particularly renal. FAR can be used as an inflammatory biomarker to monitor SLE disease activity.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 172-176"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lupus profundus in a three years old boy with a favorable response to hydroxychloroquine and steroids: Case report & a comprehensive case-based review","authors":"Hamad A. Alfahaad ,&nbsp;Anwar A. Farhan ,&nbsp;Ola A. Farhan ,&nbsp;Ammar A. Farhan ,&nbsp;Hussain H. Alhatailah ,&nbsp;Rashad A. Feddah ,&nbsp;Soliman A. Alsaiari","doi":"10.1016/j.ejr.2025.08.002","DOIUrl":"10.1016/j.ejr.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>To ensure patients receive timely dermatologic care, dermatologists and rheumatologists must be fully aware of the full range of cutaneous diseases in systemic lupus erythematosus (SLE).</div></div><div><h3>Aim of the work</h3><div>This report aims to highlight a rare presentation of lupus profundus in a pre-school aged boy to highlight diagnostic challenges, management, and outcome. Similar juvenile cases worldwide are also presented for a comparison via a comprehensive review of existing literature.</div></div><div><h3>Case presentation</h3><div>A three-year-old Saudi boy of non-consanguineous parents and with six healthy siblings, presented at two years of age with multiple 1–2 cm firm, erythematous, indurated and mildly tender subcutaneous nodules and plaques on the right upper-arm and lower-extremities. Some lesions were ulcerative with suppurative discharge. There were no systemic symptoms of fever, arthritis, or photosensitivity, making the diagnosis of SLE unlikely. Anti-nuclear antibody (ANA) was negative and complements normal. Skin biopsy revealed perivascular lymphohistiocytic infiltrate mixed with plasma cells, follicular plugging, superficial telangiectasia, dermal fibrosis, lobular and septal panniculitis and hyaline fat necrosis. The patient received potent topical steroid twice daily, and hydroxychloroquine (HCQ) 5 mg/kg, and prednisolone 5 mg oral daily. At 8-weeks, there was complete clinical resolution, with residual mild lipoatrophy. A 1-year follow-up found no recurrence or progression to SLE.</div></div><div><h3>Conclusion</h3><div>The diagnosis of lupus profundus in children is confirmed by biopsy and early intervention using HCQ, local and systemic steroid therapy can noticeably lead to rapid complete remission and to minimize cosmetic and psychosocial sequelae. Long-term follow-up is recommended to monitor for recurrence or SLE progression in the pediatric population.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 221-226"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical cognitive dysfunction in systemic lupus erythematosus patients: Insights from clinical and electrophysiological measures","authors":"Esraa M. Seif El-Din ,&nbsp;Ahmed K. Mohamed ,&nbsp;Dina F. Osman","doi":"10.1016/j.ejr.2025.09.001","DOIUrl":"10.1016/j.ejr.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive dysfunction is common in systemic lupus erythematosus (SLE) with considerable impact on patients’ quality of life.</div></div><div><h3>Aim of the work</h3><div>To evaluate cognitive function in SLE patients with (NPSLE) and without (non-NPSLE) neuropsychiatric involvement and their association with disease parameters.</div></div><div><h3>Patients and methods</h3><div>The study included 30 SLE patients (15 NPSLE and 15 non-NPSLE) and 30 matched controls. Cognitive evaluation included the mini-mental state examination (MMSE), symbol digit modalities test (SDMT) and electrophysiological event-related potentials (P300). Audiological assessment was performed. The SLE disease activity index (SLEDAI) was assessed.</div></div><div><h3>Results</h3><div>Patients were 26 females and 4 males with a mean of age of 36.4 ± 6.3 years. All patients had a prolonged P300 latency, reduced P300 amplitude, lower MMSE and SDMT scores compared to the control (408.9 ± 40.08 <em>vs</em> 313.8 ± 10.72, 3.63 ± 0.8 <em>vs</em> 4.85 ± 0.9, 26.6 ± 1.1<em>vs</em> 29.17 ± 0.8 and 35.1 ± 3.06 <em>vs</em> 50.47 ± 2.54, all p &lt; 0.001). The SDMT was significantly lower in NPSLE (33.80 ± 3.61) compared to non-NPSLE (36.4 ± 1.68,p = 0.03) patients. There was a significant correlation between MMSE and P300 latency in NPSLE and non-NPSLE groups (r = -0.54, p = 0.03 and r = -0.84, p &lt; 0.001 respectively). Cognitive performance via MMSE negatively correlated with disease duration in both NPSLE and non-NPSLE (r = -0.553,p = 0.032 and r = -0.784,p = 0.001 respectively) as well as P300 latency negatively correlated significantly with disease duration in the non-NPSLE (r = 0.764,p = 0.001). The SDMT had significant predictive ability in differentiating NPSLE from non-NPSLE (sensitivity 73.3 % and specificity 60 %,p = 0.023).</div></div><div><h3>Conclusion</h3><div>Cognitive impairment is frequent in SLE patients, regardless of neuropsychiatric involvement. Early cognitive screening is warranted, and chronic disease progression rather than activity may underlie cognitive deficits.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 227-231"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}