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…
Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histoÂpathology 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 underÂlying systemic…
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 manifesÂtations 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…
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…
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…
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.
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.
Eaton et al. set out to describe the prevalence, incidence and progression of radiographic and symptomatic hand osteoarthritis (OA), and to evaluate differences according to age, sex, race and other risk factors.
HLA-B27 may be a phenotypic expression of axial spondyloarthritis (SpA), according to a large international study. The study found patients with axial SpA who were positive for HLA-B27 had more severe radiographic damage than those who were negative for HLA-B27, and three quarters of study patients with ankylosis spondyloarthritis were HLA-B27 positive.
Many women with inflammatory arthritis stop filling prescriptions for medications to treat their disease during pregnancy, putting themselves at risk of disability and joint damage. Birru Talabi et al. examined why, finding that some women discontinue their medications out of fear, while others receive conflicting advice from providers or misinformation about medication safety.