Abstract
Extra-articular manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and various spondyloarthritides including psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease-associated spondyloarthritis often involve the skin and may occur before or after diagnosis of these rheumatic diseases. Cutaneous manifestations encompass a wide range of reactions that may have a notable negative impact not only on the physical but especially on the emotional and psychosocial well-being of these patients. Several cutaneous manifestations have been related to rheumatoid arthritis such as subcutaneous nodules including classical rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid nodulosis; vascular disorders like rheumatoid vasculitis, livedo racemosa, and Raynaud’s phenomenon; and neutrophilic and/or granulomatous diseases like pyoderma gangrenosum, Sweet’s syndrome, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with arthritis, as well as palisaded neutrophilic and granulomatous dermatitis. In juvenile idiopathic arthritis, the main cutaneous manifestations include an evanescent rash, rheumatoid nodules, as well as plaque and guttate psoriasis. Plaque psoriasis is also the main skin disease involved in spondyloarthritides. Furthermore, other forms of psoriasis including guttate, inverse, erythrodermic, pustular, and particularly nail psoriasis may also occur. In addition, a variety of drug-induced skin reactions may also appear in these diseases. Early recognition and understanding of these different dermatologic manifestations together with an interdisciplinary approach are often needed to optimize management of these diseases.
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Abbreviations
- RA:
-
Rheumatoid arthritis
- RF:
-
Rheumatoid factor
- HLA:
-
Human leukocyte antigen
- DMARDs:
-
Disease modifying anti-rheumatic drugs
- IL:
-
Interleukin
- TNF:
-
Tumor necrosis factor
- RV:
-
Rheumatoid vasculitis
- ND:
-
Neutrophilic dermatoses
- RND:
-
Rheumatoid neutrophilic dermatitis
- PG:
-
Pyoderma gangrenosum
- PMN:
-
Polymorphonuclear leucocytes
- CD:
-
Cluster of differentiation
- NSAIDs:
-
Non-steroidal anti-inflammatory drugs
- PNGD:
-
Palisaded neutrophilic and granulomatous dermatitis
- JIA:
-
Juvenile idiopathic arthritis
- MAS:
-
Macrophage activation syndrome
- Th-1:
-
T helper 1 cell
- GPP:
-
Generalized pustular psoriasis
- AGEP:
-
Acute generalized exanthematous pustulosis
- PPP:
-
Palmoplantar pustulosis
- KOH:
-
Potassium hydroxide test
- VDRL:
-
Venereal disease research laboratory test
- ReA:
-
Reactive arthritis
- IBD:
-
Inflammatory bowel disease
- UC:
-
Ulcerative colitis
- SAPHO:
-
Synovitis, acne, pustulosis, hyperostosis, and osteitis
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Carolyn Jean Chua-Aguilera, Burkhard Möller, and Nikhil Yawalkar declare that they have no conflict of interest.
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Chua-Aguilera, C.J., Möller, B. & Yawalkar, N. Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides. Clinic Rev Allerg Immunol 53, 371–393 (2017). https://doi.org/10.1007/s12016-017-8632-5
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DOI: https://doi.org/10.1007/s12016-017-8632-5