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Tenosynovitis with rice body formation presenting as a cutaneous abscess
Sara Moreno1, Pau Forcada, Xavier Soria
1Department of Dermatology, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRB Lleida, Lleida, Spain.
Journal of Cutaneous Pathology
|March 29, 2014
Summary
This case report details a rare instance of non-infectious rice body tenosynovitis presenting as a skin lesion. Surgical removal led to complete recovery, highlighting the importance of recognizing this unusual presentation.
Area of Science:
- Rheumatology
- Dermatology
- Pathology
Background:
- Rheumatoid arthritis patients may develop unusual tenosynovitis.
- Tenosynovitis can manifest with atypical symptoms, mimicking infections.
Observation:
- A 62-year-old woman with rheumatoid arthritis presented with a thumb lesion resembling infection.
- Clinical exam revealed a nodule with drainage of rice grain-like structures.
- Histopathology showed amorphous material and fibrin, with negative infectious workup.
Findings:
- Magnetic resonance imaging confirmed distended flexor sheaths with nodular lesions.
- A diagnosis of non-infectious rice body tenosynovitis was established.
- Surgical excision resulted in full recovery without recurrence.
Implications:
- This is the first reported case of rice body tenosynovitis presenting as a pseudoinflammatory cutaneous lesion with fistula formation.
- Recognizing this peculiar presentation is crucial for accurate diagnosis and management.
- This case expands the clinical spectrum of tenosynovitis in rheumatoid arthritis.
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