Outcomes and Complications of Corticosteroid Injection of Rheumatoid Nodules

Area of Science:

• Dermatology
• Rheumatology
• Cutaneous Manifestations of Systemic Disease

Background:

• Rheumatoid nodules (RN) are common extra-articular manifestations of rheumatoid arthritis.
• RN can cause significant discomfort and cosmetic concerns for patients.
• This study evaluates corticosteroid injections for RN treatment effectiveness and complications.

Observation:

• A repeated measures design assessed 66 symptomatic RN after corticosteroid injection.
• Patients were reassessed at four months for size reduction, softening, and complications.
• Mean RN diameter decreased by 42% (0.21 cm) four months post-injection.

Findings:

• 100% of patients reported reduced pain, and 77% experienced softening.
• Common side effects included cutaneous atrophy (70%) and hypopigmentation.
• Nodule recurrence occurred in 53% within 12 months, with 47% requiring surgical removal.

Implications:

• Corticosteroid injections offer short-term relief for smaller RN.
• Larger RN (≥2cm) pose a higher infection risk, favoring lower doses or surgery.
• Long-term management emphasizes systemic antirheumatic therapy with a treat-to-target approach.