No one-size-fits-all approach exists for the care and treatment of patients with systemic sclerosis (SSc) and SSc with pulmonary involvement. Here, experts discuss some best clinical practices for these patients.
Gout Experts Share Insights Into a Variety of Challenging Gout Scenarios
Although the diagnosis and treatment of gout are sometimes straightforward, practitioners encounter challenges in patients with atypical presentations, as well as those with medically complex situations or refractory disease. Here, gout experts share insights into some of these scenarios. Flare in Hospitalized Patients When not contraindicated, the 2020 ACR Guideline for the Management of Gout…
ACR Image Competition 2021 Results, Part 4
Lichenoid Cutaneous Lupus Erythematosus Mimicking Acanthosis Nigricans The photos depict a 45-year-old woman who presented to the Lupus Clinic of the University of São Paulo, Brazil, with lesions closely resembling acanthosis nigricans on her neck (A and B). The lesions had been present for four months. The patient had lived with systemic lupus erythematosus (SLE)…
Image Case Report: Refractory, Acute, Cutaneous Lupus
A 25-year-old Mexican American woman with a five-year history of systemic lupus erythematosus (SLE) presents with refractory, acute cutaneous lupus erythematosus (ACLE) and subacute cutaneous lupus erythematosus (SCLE) affecting the scalp, face and hands. Her serologic phenotype is characterized by elevated anti-nuclear, anti-double-stranded deoxyribonucleic acid (dsDNA), anti-ribonucleoprotein (RNP), anti-Smith and anti-SS-A (Ro) antibodies and chronically…
Case Report: Abscess as a Manifestation of Autoinflammatory Disease
Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histopathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with underlying systemic…
Case Report: A Bullous Eruption
Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti-neutrophil cytoplasmic antibody-associated vasculitis typically characterized by asthma, peripheral eosinophilia and medium- to small-vessel necrotizing vasculitis. Cutaneous manifestations in EGPA are diverse. Palpable purpura is the most common presentation, but urticaria, erythematous macules and papules, livedo reticularis, digital necrosis and cutaneous nodules have also been described.1 Non-hemorrhagic bullae…
Where Mental Health & Rheumatology Overlap
Because rheumatologists and mental health experts both treat patients with depression, anxiety, pain, disability and sleep disorders, provider cross-training may benefit patients and providers themselves. “When a patient has active psychosocial distress, this has a negative effect on their physical function. Similarly, if a patient has active physical symptoms, like a rheumatoid arthritis flare, this…
Gene Profiling May Predict Treatment Response in Refractory Rheumatoid Arthritis
NEW YORK (Reuters Health)—In patients with rheumatoid arthritis (RA) refractory to treatment with rituximab or tocilizumab, genetic profiling of synovial biopsies predicted the lack of therapeutic response better than a model using only tissue pathology or clinical factors, researchers say.1 “We believe this study is a paradigm shift in precision medicine in RA,” Dr. Costantino…
Researchers Should Use ACR/EULAR Definition of RA Remission in Clinical Studies
Clinical trials in rheumatoid arthritis (RA) should use the new ACR/EULAR remission definition rather than the Disease Activity Score-28-CRP, which does not sufficiently reflect patient outcomes, according to an ACR/EULAR committee.
European Medicines Agency Committee Issues Positive Opinion for Secukinumab in Pediatric Arthritic Disease
In the E.U., secukinumab is edging closer to approval for use in pediatric patients with juvenile idiopathic arthritis (JIA), specifically those with enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (PsA). In May, the Committee for Medicinal Products for Human Use of the European Medicines Agency issued a positive opinion on expanding its indications.
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