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Isolated nail fold vasculitis in rheumatoid arthritis
R A Watts1, D M Carruthers, D G Scott
1Department of Rheumatology, Norfolk and Norwich Hospital, United Kingdom.
Annals of the Rheumatic Diseases
|November 1, 1995
Summary
Isolated nail fold vasculitis (NFV) in rheumatoid arthritis (RA) patients is generally favorable. While some complications may arise, the risk of developing severe systemic vasculitis remains low.
Area of Science:
- Rheumatology
- Dermatology
- Clinical Medicine
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Vasculitis can manifest in various forms, including nail fold involvement.
- The clinical significance of isolated nail fold vasculitis (NFV) in RA requires further elucidation.
Purpose of the Study:
- To determine the clinical significance and prognosis of isolated nail fold vasculitis (NFV) in patients diagnosed with rheumatoid arthritis (RA).
Main Methods:
- Prospective follow-up of 30 RA patients diagnosed with isolated NFV by a single observer using unaided vision.
- NFV defined as nail edge or nail fold lesions without evidence of systemic or extra-articular vasculitis.
- Median follow-up duration of 22 months.
Main Results:
- Three patients died within three months of NFV diagnosis.
- Six patients developed complications potentially related to extra-articular disease, including xerostomia, pericarditis, pleural effusion, empyaema, and pulmonary fibrosis.
- No patients progressed to systemic vasculitis.
Conclusions:
- Isolated nail fold vasculitis (NFV) in RA patients demonstrates a favorable prognosis when compared to systemic vasculitis.
- The risk of developing severe systemic or extra-articular disease following isolated NFV is low.