SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
Interactions between an individual’s genetic background and their exposure to environmental factors are thought to result in a cascade of immune reactions, ultimately leading to the development of autoimmune diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and juvenile dermatomyositis.1,2 For example, an environmental factor that conclusively affects susceptibility…
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
Diagnosing orbital disease in patients with rheumatic conditions
A review of data on antinuclear antibodies and tests for rheumatoid arthritis
Inside the pathophysiology, clinical presentations of chronic pruritus
A variable combination of interstitial lung disease, myopathy, fever, joint involvement, and mechanic’s hands characterize this systemic autoimmune syndrome
Although initially given as replacement therapy for patients with primary and secondary immunodeficiency states, intravenous immunoglobulin (IVIg) has proven to be effective in the treatment of various autoimmune and inflammatory disorders. This success has led to a dramatic increase in the use of IVIg, with its use as an antiinflammatory agent now vastly surpassing its use in the treatment of immunodeficiencies. Even so, the basis for the antiinflammatory activity of IVIg remains unclear.