Rheumatoid nodulosis is a cutaneous condition associated with rheumatoid arthritis, characterized by the appearance of multiple nodules, most often on the hands.[1]
The classic description of rheumatoid nodulosis in adults is that it is a variation of rheumatoid arthritis (RA) that appears as a proliferation of subcutaneous nodules, frequently on the hands and feet, linked to palindromic rheumatism without loss of joint function and with minimal to no systemic symptoms.[2]
Mechanismedit
There are numerous theories regarding the pathophysiology of nodules linked to RA, and none of them are entirely accepted.[2] Some have hypothesised that minor local trauma to small blood vessels induces nodules by causing rheumatoid factor-containing immune complexes to pool.[3] It is believed that these immune complexes cause the release of chemotactic factors by activating nearby macrophages. More macrophages are drawn in by this process, which ultimately results in the formation of granulomas with central necrosis.[2] Some have proposed theories regarding the role of underlying vasculitis or genetic factors in the development of RA nodules.[4][5]
Treatmentedit
Generally, there is no need for treatment for the lesions; however, on rare occasions, nonsteroidal anti-inflammatory medications or intralesional corticosteroids may be necessary. In patients with severe local discomfort who are highly symptomatic, resection may be an option.[6]
Epidemiologyedit
About 20% of people with rheumatoid arthritis develop rheumatoid nodules, which are linked to more severe erosive disease in those patients.[2] The nodules are more common in men, typically manifest in the fifth decade of life, and are primarily found on extensor surfaces like the backs of the fingers and elbows, though they can occur anywhere.[7]
^L, Sokoloff; RT, McCLUSKEY (1953). "The vascularity of the early subcutaneous nodules of rheumatoid arthritis". Bulletin of the New York Academy of Medicine. 29 (9). Bull N Y Acad Med: 733–734. ISSN 0028-7091. PMC1877362. PMID 13082347.
^Panayi, G S; Wooley, P; Batchelor, J R (November 11, 1978). "Genetic basis of rheumatoid disease: HLA antigens, disease manifestations, and toxic reactions to drugs". BMJ. 2 (6148): 1326–1328. doi:10.1136/bmj.2.6148.1326. ISSN 0959-8138. PMC1608410. PMID 719380.
^Álvarez-Chinchilla, P.J.; Poveda Montoyo, I.; Illán, F.; Bañuls Roca, J. (2019). "Rheumatoid Nodulosis in an Adult Patient Negative for Rheumatoid Factor". Actas Dermo-Sifiliográficas (English Edition). 110 (10). Elsevier BV: 865–867. doi:10.1016/j.adengl.2018.06.028. ISSN 1578-2190.
^García-Patos, Vicente (2007). "Rheumatoid Nodule". Seminars in Cutaneous Medicine and Surgery. 26 (2). Frontline Medical Communications, Inc.: 100–107. doi:10.1016/j.sder.2007.02.007. ISSN 1085-5629. PMID 17544962.
Further readingedit
Maldonado, Irama; Eid, Hala; Rodriguez, Graciela R.; Rillo, Oscar L.; Barcat, Jose A.; Reginato, Antonio J. (2003). "Rheumatoid Nodulosis". JCR: Journal of Clinical Rheumatology. 9 (5). Ovid Technologies (Wolters Kluwer Health): 296–305. doi:10.1097/01.rhu.0000090260.82835.64. ISSN 1076-1608. PMID 17041479. S2CID 28531921.
Enginar, Ayşe Ünal (May 14, 2019). "Accelerated Nodulosis in a Patient With Rheumatoid Arthritis". Archives of Rheumatology. 34 (2). The Archives of Rheumatology: 225–228. doi:10.5606/archrheumatol.2019.7020. ISSN 2148-5046. PMC6719578. PMID 31497770.
External linksedit
January 01, 1970
rheumatoid, nodulosis, cutaneous, condition, associated, with, rheumatoid, arthritis, characterized, appearance, multiple, nodules, most, often, hands, other, namesaccelerated, rheumatoid, nodulosis, specialtydermatology, contents, signs, symptoms, mechanism, . Rheumatoid nodulosis is a cutaneous condition associated with rheumatoid arthritis characterized by the appearance of multiple nodules most often on the hands 1 Rheumatoid nodulosisOther namesAccelerated rheumatoid nodulosis 1 SpecialtyDermatology Contents 1 Signs and symptoms 2 Mechanism 3 Treatment 4 Epidemiology 5 See also 6 References 7 Further reading 8 External linksSigns and symptoms editThe classic description of rheumatoid nodulosis in adults is that it is a variation of rheumatoid arthritis RA that appears as a proliferation of subcutaneous nodules frequently on the hands and feet linked to palindromic rheumatism without loss of joint function and with minimal to no systemic symptoms 2 Mechanism editThere are numerous theories regarding the pathophysiology of nodules linked to RA and none of them are entirely accepted 2 Some have hypothesised that minor local trauma to small blood vessels induces nodules by causing rheumatoid factor containing immune complexes to pool 3 It is believed that these immune complexes cause the release of chemotactic factors by activating nearby macrophages More macrophages are drawn in by this process which ultimately results in the formation of granulomas with central necrosis 2 Some have proposed theories regarding the role of underlying vasculitis or genetic factors in the development of RA nodules 4 5 Treatment editGenerally there is no need for treatment for the lesions however on rare occasions nonsteroidal anti inflammatory medications or intralesional corticosteroids may be necessary In patients with severe local discomfort who are highly symptomatic resection may be an option 6 Epidemiology editAbout 20 of people with rheumatoid arthritis develop rheumatoid nodules which are linked to more severe erosive disease in those patients 2 The nodules are more common in men typically manifest in the fifth decade of life and are primarily found on extensor surfaces like the backs of the fingers and elbows though they can occur anywhere 7 See also editRheumatoid neutrophilic dermatitis Rheumatoid nodule List of cutaneous conditionsReferences edit a b Rapini Ronald P Bolognia Jean L Jorizzo Joseph L 2007 Dermatology 2 Volume Set St Louis Mosby ISBN 978 1 4160 2999 1 a b c d Evangelisto Amy 2003 Rheumatoid Nodulosis JCR Journal of Clinical Rheumatology 9 5 Ovid Technologies Wolters Kluwer Health 287 290 doi 10 1097 01 rhu 0000089982 58867 73 ISSN 1076 1608 PMID 17041477 Ziff Morris 1990 The rheumatoid nodule Arthritis amp Rheumatism 33 6 Wiley 761 767 doi 10 1002 art 1780330601 ISSN 0004 3591 PMID 2194460 L Sokoloff RT McCLUSKEY 1953 The vascularity of the early subcutaneous nodules of rheumatoid arthritis Bulletin of the New York Academy of Medicine 29 9 Bull N Y Acad Med 733 734 ISSN 0028 7091 PMC 1877362 PMID 13082347 Panayi G S Wooley P Batchelor J R November 11 1978 Genetic basis of rheumatoid disease HLA antigens disease manifestations and toxic reactions to drugs BMJ 2 6148 1326 1328 doi 10 1136 bmj 2 6148 1326 ISSN 0959 8138 PMC 1608410 PMID 719380 Alvarez Chinchilla P J Poveda Montoyo I Illan F Banuls Roca J 2019 Rheumatoid Nodulosis in an Adult Patient Negative for Rheumatoid Factor Actas Dermo Sifiliograficas English Edition 110 10 Elsevier BV 865 867 doi 10 1016 j adengl 2018 06 028 ISSN 1578 2190 Garcia Patos Vicente 2007 Rheumatoid Nodule Seminars in Cutaneous Medicine and Surgery 26 2 Frontline Medical Communications Inc 100 107 doi 10 1016 j sder 2007 02 007 ISSN 1085 5629 PMID 17544962 Further reading editMaldonado Irama Eid Hala Rodriguez Graciela R Rillo Oscar L Barcat Jose A Reginato Antonio J 2003 Rheumatoid Nodulosis JCR Journal of Clinical Rheumatology 9 5 Ovid Technologies Wolters Kluwer Health 296 305 doi 10 1097 01 rhu 0000090260 82835 64 ISSN 1076 1608 PMID 17041479 S2CID 28531921 Enginar Ayse Unal May 14 2019 Accelerated Nodulosis in a Patient With Rheumatoid Arthritis Archives of Rheumatology 34 2 The Archives of Rheumatology 225 228 doi 10 5606 archrheumatol 2019 7020 ISSN 2148 5046 PMC 6719578 PMID 31497770 External links edit Retrieved from https en wikipedia org w index php title Rheumatoid nodulosis amp oldid 1206421134, wikipedia, wiki, book, books, library,
