Cutaneous Manifestations of Rheumatoid Arthritis

Many cutaneous manifestations have been described in patients with Rheumatoid Arthritis (RA).Percentage of cutaneous manifestations varies from country to country.Only few studies and limited literature are available as on date.Skin manifestations in RA can be related to the disease or due to medications used to treat RA. METHODSFrom June 2014, 100 consecutive patients fulfilling the revised 1987 American College of Rheumatology (ACR) classification criteria for RA were taken up for this study.Late onset RA & Juvenile Idiopathic Arthritis were excluded.All patients were routinely evaluated for the skin manifestations with the dermatologist.Immunological tests RF & Anti CCPAb were done. RESULTSIn our study, 97 were females & 3 were males.7% were in 21-30 years, 24% in 31-40 years, 40% in 41-50 years age group and 29% in 51-60 years age group.38% had disease duration below 2 years, 42% of patients had 2-5 years disease duration & 20% had more than 5 years duration.RF positivity was noted in 73% of the patients.32 patients were tested for Anti-CCPAb, of whom 20 (62.5%) were positive.26% of patients had comorbidities (type-2 DM, SHT, Hypothyroidism, CAD, Dyslipidemia).In our study, 15% of patients had cutaneous manifestations like rheumatoid nodules (4%), herpes (1%) and chloroquine induced skin manifestations (10%) in the form of hypo & hyperpigmentation, rashes, dry skin and allergic reactions.7 patients (46.7%) with skin manifestations were in the 41-50 years age group.14 (93%) of them were females and 1 (6.6%) male.5 (44%) of them had disease duration of < 2 years whereas 10 (66%) patients had >2 years.12 out of 15 patients with skin manifestations (80%) had RF positivity.Anti-CCP positivity was 60% in these patients. CONCLUSIONSCutaneous manifestations due to drugs are more common than disease per se.Thus, understanding the aetiology and management for cutaneous manifestations of RA will optimize patient care.