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Published on: June 23, 2014
Rheumatoid nodule
1Department of Dermatology, Hospital Universitario Vall d'Hebron, Professor of Dermatology, Universidad Autónoma de Barcelona, Barcelona, Spain. vicente.briones@terra.es
Seminars in Cutaneous Medicine and Surgery
|June 5, 2007
Summary
Rheumatoid nodules, common in rheumatoid arthritis, can appear in various clinical settings. Accelerated nodulosis may occur with certain rheumatoid arthritis treatments, while pseudorheumatoid nodules are seen in children.
Area of Science:
- Rheumatology and Dermatology
- Immunology and Pathology
Background:
- Rheumatoid nodules are the most frequent extra-articular manifestation of rheumatoid arthritis (RA).
- While rheumatologists typically manage RA patients, dermatologists may encounter rheumatoid nodules, necessitating diagnostic and therapeutic considerations.
- These nodules can occur in diverse clinical contexts beyond classic RA presentations.
Purpose of the Study:
- To provide a comprehensive overview of rheumatoid nodules.
- To detail the clinical, pathogenic, diagnostic, and therapeutic aspects of rheumatoid nodules.
- To discuss variations like accelerated rheumatoid nodulosis and pseudorheumatoid nodules.
Main Methods:
- Review of clinical, pathogenic, diagnostic, and therapeutic literature on rheumatoid nodules.
- Analysis of associations between rheumatoid nodules and specific RA treatments.
- Comparison of true rheumatoid nodules with pseudorheumatoid nodules.
Main Results:
- Classic rheumatoid nodules are linked to genetic predisposition, severe RA, and seropositive status.
- Accelerated rheumatoid nodulosis, characterized by multiple nodules and recurrent joint symptoms, is reported with methotrexate, anti-TNF biologic drugs, and leflunomide.
- Pseudorheumatoid nodules, histologically similar to true nodules, have been observed in healthy children and may represent deep granuloma annulare.
Conclusions:
- Rheumatoid nodules exhibit varied clinical presentations and associations.
- Certain RA therapies can precipitate accelerated rheumatoid nodulosis.
- Distinguishing true rheumatoid nodules from pseudorheumatoid nodules is important for accurate diagnosis and management.
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