1/51. Interstitial granulomatous dermatitis with plaques.We report on the clinical and histopathologic findings of four patients who had asymptomatic, erythematous to violaceous plaques symmetrically distributed on the upper aspect of the thighs, lateral chest, and in two cases also on the abdomen and flexor surface of the elbows. All of the patients were women; two of them had arthritis, which in one case was associated with an autoimmune disorder, and another had autoimmune thyroiditis. Histopathologically, all cases showed similar changes consisting of an interstitial granulomatous dermatitis involving mostly the lower reticular dermis. histiocytes were the predominant cellular component, arranged interstitially and in small palisades around foci of degenerated collagen bundles in concert with large numbers of neutrophils and eosinophils. Interstitial granulomatous dermatitis can present different clinical expressions, including linear cords, papules, and, as in our cases, plaques. This peculiar histopathologic pattern falls into the spectrum of cutaneous extravascular necrotizing granuloma, a condition that is often associated with systemic autoimmune disease.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/51. Atypical methotrexate dermatitis and vasculitis in a patient with ankylosing spondylitis.Reports of histologically proven low-dose methotrexate (MTX)-induced vasculitis are uncommon and mostly found for patients with rheumatoid arthritis. Herein we present a patient with ankylosing spondylitis who developed large atypical erythematopurpuric cutaneous lesions after the second oral dose of 7.5 mg MTX therapy. The histological findings of a cutaneous lesion were consistent with vasculitis. The skin lesions regressed significantly after the discontinuation of MTX therapy. As the clinical picture of the patient's rheumatological condition became progressively severe, prednisolone therapy was initiated 8 days later and the skin rash resolved completely in a couple of weeks.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
3/51. The CINCA syndrome: a rare cause of chronic arthritis and multisystem inflammatory disorders.Chronic infantile neurological cutaneous articular (CINCA) syndrome is a rare disorder with neonatal onset characterised by a chronic progressive inflammatory process with skin rash, articular and central nervous system involvement. This primary systemic inflammatory disorder should be distinguished from juvenile rheumatoid arthritis (JRA). Although the articular findings are characteristic features of CINCA syndrome, there is a certain degree of variability in the articular involvements which are not always symmetrical nor is the degree of severity uniform. The etiology of CINCA syndrome remains unknown. No single treatment has been found to be effective. This syndrome is known in the American medical literature as infantile onset multisystem inflammatory disease (IOMID).- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
4/51. Interstitial granulomatous dermatitis with cutaneous cords and arthritis: a disorder associated with autoantibodies.Interstitial granulomatous dermatitis with arthritis is a new entity characterized by linear or arciform subcutaneous cords. We describe a patient presenting with typical cutaneous lesions extending from the anterior and posterior part of the axillae to the flank. The lesions had been present for 6 years with flares and remission. Histopathologic examination revealed a bandlike infiltrate of histiocytes in the reticular dermis with focal areas of palisading around necrotic collagen bundles. A few atypical histiocytes were also present. As previously described, it was associated with serologic findings of an autoimmune disease, especially high titers of anti-dna antibodies. The possible inclusion of the interstitial granulomatous dermatitis in the continuous spectrum of the palisaded neutrophilic and granulomatous dermatitis of immune complex disease is also discussed.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
5/51. Rheumatoid neutrophilic dermatitis in a woman with seronegative rheumatoid arthritis.Rheumatoid neutrophilic dermatitis (RND) is an unusual cutaneous reaction in patients with rheumatoid arthritis (RA). RND is characterized by symmetric, erythematous papules, plaques, nodules, and urticarial lesions often located over the joints, extensor surfaces of the extremities, or the trunk. This entity demonstrates an intense neutrophilic dermal infiltrate without vasculitis. All patients previously reported with RND had severe RA with relatively high titers of rheumatoid factor when tested. A 67-year-old woman had a 2-month history of multiple, tender, 4 to 8 mm erythematous, crusted papules and nodules that occurred in clusters on her anterior thighs, knees, and legs. She suffered from severe disabling seronegative RA. RND may complicate seronegative RA.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
6/51. Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation of seronegative rheumatoid arthritis.Rheumatoid neutrophilic dermatitis (RND) is an uncommon, but distinctive manifestation of rheumatoid arthritis (RA). We describe the case of a 35-year-old female who developed RND as an early stage of seronegative RA. Clinically, the lesions were presented by erythematous, slightly tender, papules, 5-10 mm in diameter, on the extensor surface of the left arm. The histopathological findings revealed a dense, dermal, mainly neutrophilic infiltrate, with prominent leucocytoclasia, but without any features of vasculitis. There was fibrinoid degeneration of collagen, resembling the collagen changes present in rheumatoid nodules in a miniaturized form. RND can be a reliable, early clinical sign of RA, as seen in our patient. Furthermore, this case demonstrates that RND may be associated not only with seropositive RA, as described in the literature, but also with seronegative RA, never before reported. The histological findings in our case are remarkable because of the fibrinoid collagen degeneration, which is described here for the first time in RND. Thus, RND may, in fact, be the initial phase of a spectrum that begins with a neutrophilic reaction and mild fibrinoid collagen degeneration, and evolves into rheumatoid nodules at the final stage.- - - - - - - - - - ranking = 5keywords = arthritis (Clic here for more details about this article) |
7/51. Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis.Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords and arthritis, rheumatoid papules, and Churg-Strauss granuloma. We report 7 additional cases of PNGD. Clinically, 6 patients presented with erythematous to violaceous plaques, papules, and nodules on multiple body sites; one presented with subcutaneous linear bands on the shoulder. Five had rheumatoid arthritis; one had adult-onset Still's disease; and one showed clinical signs of rheumatoid arthritis, although serologically the rheumatoid factor was negative. On histologic examination, a spectrum of changes was observed ranging from urticaria-like infiltrates to leukocytoclastic vasculitis and granuloma annulare with neutrophils. We report these cases to expand the histologic spectrum of this entity and to further delineate the different forms of clinical presentation.- - - - - - - - - - ranking = 8keywords = arthritis (Clic here for more details about this article) |
8/51. Introduction to some common cutaneous foot conditions and their management.Problems that happen to the body through injury or disease can also happen to the owner's feet, and there are additional complications associated with the feet. Feet are a long way from the core, are in contact with an unclean environment (the ground), can be abused through poor-fitting footwear and are subjected to more general wear and tear than many other parts of the body. There are a large number of conditions affecting the feet, many associated with medical disorders such as diabetes, rheumatoid arthritis or peripheral vascular disease. The symptom of pain often triggers help being sought, but change in the appearance of the skin is a very important indicator of the state of superficial and deeper tissues. health-care professionals may be called upon to comment on these conditions and treat and/or refer accordingly, so a multidisciplinary approach is required. Clinical skill is required to identify the conditions which are treatable, or those which should be referred for treatment by someone in another specialism. This paper provides information for clinicians and interested others in the form of an introduction to some common cutaneous foot conditions through outline case examples and their treatment.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
9/51. Arthritis and interstitial granulomatous dermatitis (Ackerman syndrome) with pulmonary silicosis.OBJECTIVE: To describe the case of a patient suffering from pulmonary silicosis associated with a rheumatoid factor negative, antinuclear antibody positive, symmetrical, nonerosive synovitis, and interstitial granulomatous dermatitis (IGD) and compare it with similar cases reported in the literature. methods: literature search to identify published cases of IGD with arthritis and cases associated with silicosis. RESULTS: Thiry-eight cases of IGD with arthritis were found. These cases were associated with various conditions such as drug reactions, autoimmune diseases, chronic infections, or paraneoplastic syndromes for which no specific underlying cause was identified. The patient had skin lesions corresponding to the rope sign, as noted in other reports. histology showed a histiocytic, granulomatous dermatitis, which, in association with arthritis, was first described by Ackerman et al. Circulating immune complexes or altered apoptosis have been discussed as mechanisms, although there is no experimental evidence to support either hypothesis. As in other cases, treatment had limited success. Most relief was achieved with hydroxychloroquine, dapsone, and corticosteroids. CONCLUSIONS: Arthritis and IGD associated with silicosis is a rare clinical entity that can be differentiated from other conditions. This condition should be considered when patients present with typical dermatologic features, such as the rope sign, and arthritis.- - - - - - - - - - ranking = 4keywords = arthritis (Clic here for more details about this article) |
10/51. Interstitial granulomatous dermatitis with plaques and arthritis.Interstitial granulomatous dermatitis (IGD) is a histopathological disorder characterised by an infiltration of the reticular dermis with a predominance of interstitial and palisadic histiocytes with a few areas of degenerating collagen bundles associated with a variable number of polynuclear neutrophils and eosinophils. There are several clinical conditions with a pattern of IGD. The linear form associated with arthritis was the first variety described. There is also a second form, which presents with plaques. This variety may be associated with arthritis, use of certain drugs or the presence of different systemic disorders. We report a case of IGD with plaques and arthritis. We discuss the differential clinical and histological diagnosis with other inflammatory skin lesions, which may be associated with joint disorders and collagen degeneration. We believe that it should be considered in patients presenting with arthritis and skin lesions.- - - - - - - - - - ranking = 8keywords = arthritis (Clic here for more details about this article) |
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