Rheumatoid Arthritis Skin Problems

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TINA C. BUNCH
If you develop a skin rash and you didn't have it before, it's important to go see your rheumatologist and address it when it pops up. Sometimes patients come in and say, hey, look at this. What's going on with my skin? I never had this before.

Patients with rheumatoid arthritis can develop rheumatoid nodules, and it is a marker, for example, of more aggressive disease. Sometimes they're small, like the size of a marble. But sometimes they can grow quite big, almost the size of a golf ball. It is extra tissue that has developed because of the inflammation that is there from the underlying arthritis. Sometimes medications can contribute to rheumatoid nodules.

In certain cases, the rheumatologists may say, let me try a different medication. They may try either cutting down the dose or stopping it entirely and picking something else that's not going to have those issues.

We hate to put patients through unnecessary surgical procedures if it's not going to be a long-term fix. So generally, we do not recommend surgery for them.

Patients with rheumatoid arthritis can also develop vasculitis. Vasculitis is inflammation of blood vessels. And the way rheumatoid vasculitis would manifest itself typically is with strawberry red dots, hundreds of them that'll pop up on the shins or the legs, sometimes on that thighs as well. An indicator that the disease is not well-controlled, and that the rheumatologist therefore needs to get more aggressive, likely with higher doses of steroids, or pull steroids or potentially a different type of medication to control the underlying immune problem.

Rheumatologists work very closely with dermatologists when they have a situation where there's a new finding to say, hey, what could this be? Because our conditions can have wide-ranging manifestations.