It is better to be feared than loved. The associate dean of student affairs at my medical school embraced this motto. Although the dean of the medical school was titularly in charge, it was the associate dean who kept the school running. And we all feared her, just a little bit. Without ever raising her…
Glucocorticoids remain a prominent part of care for many patients with SLE but can have toxic side effects; this EULAR 2022 session discussed one institution’s approach to lower the dosage.
Teaching junior learners, such as medical students and residents, is increasingly important in rheumatology. Given the anticipated shortage of rheumatologists, attracting more trainees to our field and enhancing knowledge of the rheumatic diseases among physicians in other fields are critical to meeting the needs of our patients.1,2 In addition, clinical reasoning is a vital skill…
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…
Acute febrile neutrophilic dermatosis, or Sweet syndrome, is an inflammatory disease that classically presents with fever, leukocytosis and tender, erythematous plaques characterized by neutrophilic infiltrates on biopsy. Sweet syndrome has been reported in association with several autoimmune diseases, including inflammatory bowel disease, systemic lupus erythematous, rheumatoid arthritis and sarcoidosis.1 Here, we discuss a case of…
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.
Autoinflammatory disorders may involve genetic mutations of the inflammasome or an environmental trigger in a genetically susceptible host. Dr. Jay Mehta discussed a practical, clinical approach to caring for patients with autoinflammatory disorders, such as periodic fever syndromes, during the 2022 ACR Education Exchange.
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…
The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
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…