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Clinical Reviews in Allergy & Immunology

, Volume 53, Issue 3, pp 371–393 | Cite as

Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides

  • Carolyn Jean Chua-Aguilera
  • Burkhard Möller
  • Nikhil YawalkarEmail author
Article

Abstract

Extra-articular manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and various spondyloarthritides including psoriatic arthritis, ankylosing spondylitis, reactive arthritis, and inflammatory bowel disease-associated spondyloarthritis often involve the skin and may occur before or after diagnosis of these rheumatic diseases. Cutaneous manifestations encompass a wide range of reactions that may have a notable negative impact not only on the physical but especially on the emotional and psychosocial well-being of these patients. Several cutaneous manifestations have been related to rheumatoid arthritis such as subcutaneous nodules including classical rheumatoid nodules, accelerated rheumatoid nodulosis, and rheumatoid nodulosis; vascular disorders like rheumatoid vasculitis, livedo racemosa, and Raynaud’s phenomenon; and neutrophilic and/or granulomatous diseases like pyoderma gangrenosum, Sweet’s syndrome, rheumatoid neutrophilic dermatitis, interstitial granulomatous dermatitis with arthritis, as well as palisaded neutrophilic and granulomatous dermatitis. In juvenile idiopathic arthritis, the main cutaneous manifestations include an evanescent rash, rheumatoid nodules, as well as plaque and guttate psoriasis. Plaque psoriasis is also the main skin disease involved in spondyloarthritides. Furthermore, other forms of psoriasis including guttate, inverse, erythrodermic, pustular, and particularly nail psoriasis may also occur. In addition, a variety of drug-induced skin reactions may also appear in these diseases. Early recognition and understanding of these different dermatologic manifestations together with an interdisciplinary approach are often needed to optimize management of these diseases.

Keywords

Rheumatoid arthritis Juvenile idiopathic arthritis Spondyloarthritis Psoriasis Inflammatory bowel disease DMARDs 

Abbreviations

RA

Rheumatoid arthritis

RF

Rheumatoid factor

HLA

Human leukocyte antigen

DMARDs

Disease modifying anti-rheumatic drugs

IL

Interleukin

TNF

Tumor necrosis factor

RV

Rheumatoid vasculitis

ND

Neutrophilic dermatoses

RND

Rheumatoid neutrophilic dermatitis

PG

Pyoderma gangrenosum

PMN

Polymorphonuclear leucocytes

CD

Cluster of differentiation

NSAIDs

Non-steroidal anti-inflammatory drugs

PNGD

Palisaded neutrophilic and granulomatous dermatitis

JIA

Juvenile idiopathic arthritis

MAS

Macrophage activation syndrome

Th-1

T helper 1 cell

GPP

Generalized pustular psoriasis

AGEP

Acute generalized exanthematous pustulosis

PPP

Palmoplantar pustulosis

KOH

Potassium hydroxide test

VDRL

Venereal disease research laboratory test

ReA

Reactive arthritis

IBD

Inflammatory bowel disease

UC

Ulcerative colitis

SAPHO

Synovitis, acne, pustulosis, hyperostosis, and osteitis

Notes

Compliance with Ethical Standards

Conflict of Interest

Carolyn Jean Chua-Aguilera, Burkhard Möller, and Nikhil Yawalkar declare that they have no conflict of interest.

Funding

None.

Ethical Approval

Not applicable.

Informed Consent

Not applicable.

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© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Dermatology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland
  2. 2.Department for Rheumatology, Immunology and Allergology, Inselspital, Bern University HospitalUniversity of BernBernSwitzerland

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