Cutaneous Manifestations
Rheumatoid Arthritis
Rheumatoid Nodules
Rheumatoid nodules are the most common cutaneous manifestation of RA. These nodules were identified in 53% of hospitalized patients and 34% of outpatients with diagnosed RA, along with up to 75% of those with Felty syndrome. They are more frequently observed in males of Caucasian descent. In patients positive for rheumatoid factor (RF), 90% had rheumatoid nodules and in seronegative patients, 6% had these nodules (Hata 2006). 10
A genetic association has been recognized between formation of rheumatoid nodules and the presence of specific major histocompatibility complex class II alleles (e.g. HLA-DR4). These nodules typically present on extensor surfaces (proximal ulna, olecranon process), and are flesh colored subcutaneous nodules of varying consistency. They can be mobile, soft, and amorphous or rubbery and firm with an …show more content…
These are painless, small, purpuric to brown lesions on the digital pulp, nail edge, or nail fold that are transient. No patients with solely nail fold infarctions developed systemic vasculitis (Sayah 2005). 3
Felty Syndrome
Felty syndrome is defined by the triad of leukopenia, arthritis, and splenomegaly and occurs in 1% of patients with RA. Nearly all of the cases occur in white patients, with the average age of presentation in the fifties—nearly 16 years following initial diagnosis of RA. There is a slight female predominance (1.6:1), but males tend to develop the syndrome sooner after diagnosis of RA (Sayah 2005). 3
Dermatologic manifestations include hyperpigmentation, rheumatic nodules (76%), and leg ulcers (as much as 22%). These ulcers are often due to venous insufficiency that is worsened by vasculitis, and are deep and chronic. They occur on the ankles and shins, with subsequent extravasation of red blood cells resulting in the development of hyperpigmentation (Sayah 2005).
Rheumatoid Arthritis
Rheumatoid Nodules
Rheumatoid nodules are the most common cutaneous manifestation of RA. These nodules were identified in 53% of hospitalized patients and 34% of outpatients with diagnosed RA, along with up to 75% of those with Felty syndrome. They are more frequently observed in males of Caucasian descent. In patients positive for rheumatoid factor (RF), 90% had rheumatoid nodules and in seronegative patients, 6% had these nodules (Hata 2006). 10
A genetic association has been recognized between formation of rheumatoid nodules and the presence of specific major histocompatibility complex class II alleles (e.g. HLA-DR4). These nodules typically present on extensor surfaces (proximal ulna, olecranon process), and are flesh colored subcutaneous nodules of varying consistency. They can be mobile, soft, and amorphous or rubbery and firm with an …show more content…
These are painless, small, purpuric to brown lesions on the digital pulp, nail edge, or nail fold that are transient. No patients with solely nail fold infarctions developed systemic vasculitis (Sayah 2005). 3
Felty Syndrome
Felty syndrome is defined by the triad of leukopenia, arthritis, and splenomegaly and occurs in 1% of patients with RA. Nearly all of the cases occur in white patients, with the average age of presentation in the fifties—nearly 16 years following initial diagnosis of RA. There is a slight female predominance (1.6:1), but males tend to develop the syndrome sooner after diagnosis of RA (Sayah 2005). 3
Dermatologic manifestations include hyperpigmentation, rheumatic nodules (76%), and leg ulcers (as much as 22%). These ulcers are often due to venous insufficiency that is worsened by vasculitis, and are deep and chronic. They occur on the ankles and shins, with subsequent extravasation of red blood cells resulting in the development of hyperpigmentation (Sayah 2005).