Rheumatoid nodulosis: report of two cases

We present two patients with subcutaneous nodular lesions of several years' duration. These lesions were well defined and painless and were located next to bony surfaces or in the pulps of fingers and elbows. No other symptoms were observed except for frequent attacks of palindromic rheumatism with no evidence of arthritis or systemic manifestations suggestive of rheumatoid arthritis. Other studies performed were normal with negative results for rheumatoid factor and antinuclear antibodies. Radiographs of affected sites showed no signs of arthritis while the histopathologic study revealed some findings compatible with rheumatoid nodule. One of the patients also presented desquamate papular lesions at the level of elbows while histologically a process of transepidermal elimination of fibrinoid could be observed. Our patients fulfil all the diagnostic criteria for rheumatoid nodulosis as they present multiple rheumatoid nodules confirmed on biopsy, symptoms of palindromic rheumatism, no evidence of arthritis or radiological alterations and negative rheumatoid factor.