Cutaneous manifestations of rheumatoid arthritis

B, Prakash; CA, Jayashankar; Vm, Shivalingappa; Sa, Bhakthavatsalam; K, Chandrashekar

doi:10.15305/ijrci/v3i1/107

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…This is consistent with other studies as most rheumatic diseases especially SLE which was the most frequent diagnosis in our patients, commonly present in the 4 TH decade of life [16,17]. Most patients in our study were females (93%) which is not surprising as most rheumatological conditions show a clear female preponderance as reported by previous studies [17,18,19]. The prerequisite for inclusion in the study was presentation of a new onset cutaneous lesion in rheumatological condition; hence all our patients had skin manifestation at presentation, followed by musculoskeletal complaints and constitutional symptoms.…”

Section: Discussionsupporting

confidence: 93%

“…The mean age of presentation in our study was 38 ±10.4 years with majority of patients being in the middle age group. This is consistent with other studies as most rheumatic diseases especially SLE which was the most frequent diagnosis in our patients, commonly present in the 4 TH decade of life [16,17]. Most patients in our study were females (93%) which is not surprising as most rheumatological conditions show a clear female preponderance as reported by previous studies [17,18,19].…”

Section: Discussionsupporting

confidence: 93%

“…Even in previous studies, Rheumatoid nodule was seen as most frequent skin involvement in RA patients [24] which has been reported especially in long standing and more severe RA cases. The incidence of RA vasculitis was higher as compared to the study by Bhanuprakash et al [17], who reported an incidence of 5.8% compared to 17.4% in our study. In a autopsy study by Suzuki et al in 1994 the incidence of Vasculitis was found to be 30% among 81 autopsied RA patients [25] while a more recent study in 2015 by Cojocaru M et al describes a much lower incidence of 2-5% [26].…”

Section: Discussioncontrasting

confidence: 88%

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Study of new onset cutaneous manifestations in Rheumatic Diseases

2018

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Background: Skin manifestations are an important clue to underlying rheumatological conditions and at times the first manifestation of the disease. Their identification helps in diagnosis, classification and follow up of these diseases. Hence we conducted this study to assess the new onset cutaneous lesions in patients with rheumatic diseases and correlate skin lesions with disease activity and study the response to therapy over a period of 3 months. Materials and Methods: This prospective observational study was done in KEM Hospital, Mumbai over 18 months recruiting 78 patients, presenting to Rheumatology OPD / wards with new onset skin manifestations. Disease activity was calculated as per standard indices for each rheumatological disease. Skin lesions appearing due to adverse effects of drugs or unrelated to the disease were excluded from the study. The outcome of the skin lesions was assessed at 3 months follow up. Results: Mean age of patients was 38 years with 91% being females. SLE was the most common diagnosis. The most common skin lesions were malar rash among SLE patients; rheumatoid nodules in patients of RA; Sclerodactyly in the Scleroderma patients and Heliotrope rash amongst the dermatomyositis patients. The mean SLEDAI score in the group with LE non-specific lesions was significantly higher compared to the group with LE-specific lesions (P<0.0001). At 3 months there was statistically significant reduction in SLEDAI score after treatment in SLE patients. In patients of RA, 74% patients showed reduction in DAS 28 ESR score with treatment at 3 months. Systemic sclerosis patients failed to show significant improvement in Modified Rodnan's Skin Score after 3 months of treatment. Conclusions: Among all rheumatological conditions SLE presents most often with skin involvement. Patients with LE specific lesions have lower disease activity (SLEDAI score) as compared to LE nonspecific lesions. At 3 months follow up the response to treatment is good in SLE patients with reduction in SLEDAI scores and also in RA patients with reduction in DAS 28 ESR scores.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 88%

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Study of new onset cutaneous manifestations in Rheumatic Diseases

2018

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Cutaneous Manifestations of Rheumatoid Arthritis

T¹,

Ravichandran²,

Ramesh³

et al. 2019

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Mucocutaneous manifestations in patients with rheumatoid arthritis: A cross-sectional study from Eastern India

et al. 2017

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Background:Cutaneous manifestations are fairly common in rheumatoid arthritis (RA) and they can help in early diagnosis, prompt treatment, and hence reduced morbidity from the disease.Aims:The objective of the present study was to find out the different patterns of dermatoses in a group of patients with RA from Eastern India.Methodology:Consecutive patients fulfilling the American Rheumatism Association 1987 revised criteria for the classification of RA and who had different dermatoses were included in this cross-sectional study done over a period of 8 years in a tertiary care hospital in Eastern India. Thorough clinical examination and appropriate laboratory investigations were performed as needed. Data were recorded in a predesigned schedule, and appropriate statistical analysis was done.Results:We studied 111 evaluable patients with an age range of 19–71 years and a female to male ratio of 7:1. The mean disease duration of RA was 6.5 years. Cutaneous infections as a group was the most common mucocutaneous manifestation (34.2%) followed by xerosis including ichthyotic skin changes (27%), pigmented purpuric dermatoses (14.4%), leg ulcer (9.9%), periungual telangiectasia (9.9%), rheumatoid nodules (RNs) (8.1%), purpura and ecchymoses (7.2%), small vessel vasculitis in (7.2%), corn and callosities (6.3%), palmar erythema (4.5%), and neutrophilic dermatosis (4.5%). Raynaud's phenomenon was found in 3.6% patients and panniculitis in (3.6%) patients. Rheumatoid factor (RF) and anti-cyclic citrullinated peptides antibody were positive in 74.8% and 88.3% patients, respectively. No statistically significant difference of incidence of leg ulcer, small vessel vasculitis, RN, or Raynaud's phenomenon could be noted between RF positive and negative groups.Limitations:Being an institution-based study, the study findings may not reflect the true situation in the community which remained a limitation of this study.Conclusion:While some of the features of this study were analogous to Western data, other features showed discordance which may be due to ethnic variations among the patients with RA.

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Cutaneous manifestations of rheumatoid arthritis

Cited by 3 publications

References 14 publications

Study of new onset cutaneous manifestations in Rheumatic Diseases

Study of new onset cutaneous manifestations in Rheumatic Diseases

Cutaneous Manifestations of Rheumatoid Arthritis

Mucocutaneous manifestations in patients with rheumatoid arthritis: A cross-sectional study from Eastern India

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