Scleromyxedema is a primary cutaneous mucinosis characterized by a diffuse and generalized papular skin eruption of mucinous deposits throughout the upper dermis. In addition to dermatologic manifestations, scleromyxedema may involve the cardiopulmonary, gastrointestinal, renal and nervous systems. Dermato-neuro syndrome (DNS) is a rare, severe neurologic complication of scleromyxedema.1,2 The pathogenesis of DNS is unknown, but…
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Pearls of Wisdom from an Expert: Challenging ILD Cases with a Pulmonologist-Rheumatologist
Erin Wilfong, MD, PhD, shared her niche expertise in connective tissue disease ILD (CTD-ILD) via case-based learning during a session of the 2022 ACR Education Exchange.
Diagnostic Challenges of MIS-C
During the peak of the coronavirus pandemic in Washington, D.C., we were asked to evaluate a 14-year-old boy admitted to the pediatric hospitalist service. He had been healthy until two weeks before, when he noted a sore throat, and soon after he developed fevers and rashes without congestion, shortness of breath, conjunctivitis or swollen lymph…
New Tech Provides Insights Into the Pathogenesis of Psoriatic Arthritis
The etiology of psoriatic arthritis (PsA) is poorly understood but current evidence supports an interaction between genetic and environmental factors that coalesce to promote local tissue inflammation.1-3 The pivotal cytokines that underlie the local inflammatory response in a wide range of tissues are interleukin (IL) 23, IL-17 and tumor necrosis factor (TNF).4 The central contribution…
2 New Clinical Practice Guidelines for JIA Released
Two new ACR Clinical Practice Guidelines provide recommendations on the pharmacologic management of JIA, focusing on treatment of oligoarthritis, temporomandibular arthritis & systemic JIA, as well as nonpharmacologic therapies, medication monitoring, immunizations & imaging.
Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
Case Report: Intermittent Fevers in a Patient with pJIA
A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…
Tissue Evaluation: Understanding Rheumatoid Arthritis Inside & Out
At the 17th Annual Advances in the Diagnosis and Treatment of the Rheumatic Diseases meeting, Clifton Bingham, MD, delves into research into rheumatoid arthritis at the cellular level.
Case Report: Perplexing Pulmonary Nodules
Pulmonary nodules are common; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…
Highlights from ACR Convergence’s Late-Breaking Abstracts
COVID-19 vaccination, treatments for rheumatic disease and more—the Late-Breaking Abstracts session of ACR Convergence 2021 highlighted six studies with implications for rheumatology.
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