Related Experiment Video
Updated: Mar 2, 2026
08:05
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
5.1K
Chronic Tender Ulcers on the Calf and Both Forearms
Michael C Cameron1, Mitsuya Katayama2, Nishit S Patel3
1Department of Dermatology, University of Colorado, Aurora, CO, University of South Florida Morsani College of Medicine, Tampa, FL; michael.cameron@ucdenver.edu.
Skinmed
|May 23, 2017
Summary
This case study highlights a rare presentation of rheumatoid vasculitis in an elderly woman with nonhealing ulcers. Prompt diagnosis and treatment are crucial for managing this severe autoimmune complication.
Area of Science:
- Rheumatology
- Dermatology
- Immunology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- RA can have extra-articular manifestations, including vasculitis.
- Treatment for RA includes methotrexate, hydroxychloroquine, and prednisone.
Observation:
- An elderly woman with RA presented with 3-month history of nonhealing, tender ulcers on her right calf and forearms.
- Physical examination revealed punched-out ulcers with necrotic eschars and retiform purpura.
- Previous antibiotic treatments were ineffective.
Findings:
- The patient's clinical presentation and medical history were suggestive of rheumatoid vasculitis.
- Differential diagnoses included polyarteritis nodosa, antiphospholipid syndrome, cryoglobulinemic vasculitis, and pyoderma gangrenosum.
- The specific findings pointed towards a vasculitic process secondary to RA.
Implications:
- This case underscores the importance of considering vasculitis in RA patients with unusual skin lesions.
- Early recognition and appropriate immunosuppressive therapy are vital for managing rheumatoid vasculitis.
- This presentation highlights the diagnostic challenges and potential severity of RA-related cutaneous vasculitis.
Related Concept Videos
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
532
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
532
01:27Assessment of the Cardiovascular System III: Palpation
1.2K
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
1.2K
01:25Endocarditis II: Clinical Features of Infective Endocarditis
642
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
642
01:24Chronic Kidney Disease II: Clinical Manifestations
807
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
807
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
258
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
258
01:26Peripheral Artery Disease IV: Nursing Management
499
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
499