Detection of dermatological abnormalities in the rheumatology clinic using a standardized screening exam

To develop a standardized practical screening tool for rheumatologists to assess for underlying dermatological manifestations of rheumatic conditions.

A relevant screening tool was developed by consensus between dermatology and rheumatology authors. Patients visiting the general rheumatology clinic for routine care were systematically assessed based on the standardized screening tool.

One hundred patients were recruited with 76 being female. The most prevalent rheumatic conditions seen in the clinic were rheumatoid arthritis, psoriatic arthritis and systemic lupus erythematosus. The standardized integumentary assessment took a mean of 2.75 (SD 1.61) min. Most patients, 74%, reported no concerns with their hair or nails, while 60% reported no concerns with their skin. The majority of patients had one abnormality identified, 65%, and of those diagnoses, most affected the skin with 71% of patients having an identified skin abnormality, compared with the hair (10%) or nails (13%).

The standardized integumentary assessment tool can be successfully incorporated into routine clinical practice for rheumatologists without significant extension of consultation time and may detect relevant abnormalities important for diagnosis which may have been unnoticed by patients. It may encourage collaborative care and enhance clinical outcomes.