A 54 year-old woman with a 3-year history of rheumatoid arthritis (RA) consulted
us because of weight loss, fever and skin eruption. On physical examination,
erythematous plaques with a pseudo-vesicular appearance were seen on the back of
both shoulders. Histological examination was consistent with rheumatoid
neutrophilic dermatosis (RND). After three days of prednisone treatment, the
skin eruption resolved. RND is a rare cutaneous manifestation of seropositive
RA, characterized by asymptomatic, symmetrical erythematous plaques with a
pseudo-vesicular appearance. Histology characteristically reveals a dense,
neutrophilic infiltrate with leucocitoclasis but without other signs of
vasculitis. Lesions may resolve spontaneously or with RA treatment. This case
illustrates an uncommon skin manifestation of active rheumatoid arthritis.
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