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Systemic lupus erythematosus presenting with 'rheumatoid nodules'
J K Schofield1, R Cerio, K Grice
1Department of Dermatology, Watford General Hospital, UK.
Clinical and Experimental Dermatology
|January 1, 1992
Summary
Systemic lupus erythematosus can rarely cause rheumatoid-like nodules on fingers, presenting with arthritis and Raynaud's phenomenon. Treatment with hydroxychloroquine led to nodule resolution, suggesting a unique presentation of lupus.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
- Rheumatoid nodules are typically associated with rheumatoid arthritis but can occur in other conditions.
- The occurrence of rheumatoid-like nodules in SLE is rare and not well-characterized.
Observation:
- A patient with SLE presented with subcutaneous nodules on the fingers, accompanied by arthritis and Raynaud's phenomenon.
- Histopathology of the nodules was consistent with rheumatoid nodules.
- The patient exhibited leucopenia, positive anti-nuclear antibody, and negative rheumatoid factor.
Findings:
- Immunofluorescence confirmed SLE by showing IgM deposits at the dermo-epidermal junction in normal skin.
- The patient's nodules significantly improved with hydroxychloroquine treatment.
- The nodule distribution and clinical course were distinct from previously reported SLE cases with similar nodules.
Implications:
- This case highlights a rare presentation of SLE with rheumatoid-like nodules.
- Hydroxychloroquine may be an effective treatment for such nodules in SLE patients.
- Further research is needed to understand the pathogenesis and clinical significance of these nodules in SLE.