Tumor necrosis factor-alpha (TNF-α) antagonists are employed increasingly during recent years in patients with active rheumatoid arthritis who do not respond to disease-modifying anti-rheumatic drugs. Contraindications such as infections, auto-antibody formation and hypersensitive reactions can be observed during the treatment with TNF-α antagonist drugs. Our case was a 52-year-old woman, followed by several centers for a period of 21 years with a seropositive, erosive and nodular RA diagnosis. Anti TNF-α treatment was commenced due to the failure to control the disease. During the treatment, a serious cellulite developed, which required hospitalization and surgical debridement as well as intravenous antibiotics treatment. Through the present case, we aimed to draw attention to the skin infection during the use of etanercept in a patient with RA.

Objectives The aim of this study was to investigate the noninflammatory complaints in rheumatoid arthritis (RA) patients on remission and the relationship between these complaints and disease characteristics. Methods This is a medical records review study of 103 RA patients who sustained a remission period for at least 6 months. Clinical features and demographic characteristics of patients, such as laboratory parameters, current number of sensitive and swollen joints, pain level and Patient Global Assessment, previously used medications, and modified Health Assessment Questionnaire, were carefully recorded. Patients were divided into 2 groups according to the presence of noninflammatory complaints as patients with or without noninflammatory complaints (group 1, n = 56; group 2, n = 47, respectively). Results The most common complaints with a decreasing frequency were as follows: low back pain (n = 13 [23.2%]), degenerative knee pain (n = 11 [19.6%]), and widespread body pain due to fibromyalgia (n = 7 [12.5%]). The mean age and age at diagnosis were higher in group 1 than in those in group 2 (p = 0.039, and p = 0.014, respectively). Conclusions Noninflammatory complaints can be observed in about 50% of RA patients on remission. These complaints were more common in elderly patients with old-age disease onset. Therefore, while evaluating and treating this patient population, noninflammatory complaints and disease-specific parameters should be considered carefully in order to fully improve the clinical outcomes.