10th July 2023

Rheumatology

Rheumatoid arthritis

Specific cutaneous changes include:

• Rheumatoid nodules
• Vasculitis causing changes such as nail fold infarcts and ulcers
• Pyoderma gangrenosum

Dermatomyositis 

Skin manifestations include the classic heliotrope rash around the eyes, Gottron papules (red plaques on the extensor surfaces of finger joints), Gottron sign (erythema over knees and elbows), dilated nail fold capillaries, ragged cuticles, and nail fold infarcts. Please note that when a patient presents with dermatomyositis, this warrants an investigation for an underlying malignancy, namely bronchial, breast and ovarian.

Lupus Erythematosus

• Discoid lupus erythematosus is associated with scaly erythematous plaques with follicular plugging on sun-exposed areas of the skin. They tend to heal with scarring.
• Systemic lupus erythematosus (SLE) is commonly associated with cutaneous manifestations such as a malar rash (facial butterfly rash with purple hue), photosensitivity, vasculitis, Raynaud’s phenomenon, alopecia, and oropharyngeal ulceration.