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Livedo reticularis is a common skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin. [1] The discoloration is caused by reduction in blood flow through the arterioles that supply the cutaneous capillaries, resulting in deoxygenated blood showing as blue discoloration ().
Rheumatoid vasculitis can cause palpable purpura, ulcers, nodules, and digital necrosis on the skin. [6] Even though it is nonspecific and present in many different disorders, livedo reticularis is frequently observed. [3] Peripheral nervous system involvement is the second most common organ involved.
Livedoid vasculopathy (LV) is an uncommon thrombotic dermal vasculopathy that is characterized by excruciating, recurrent ulcers on the lower limbs. [4] Livedo racemosa, along with painful ulceration in the distal regions of the lower extremities, is the characteristic clinical appearance.
Rheumatoid nodules can also appear in areas of the body other than the skin. Less commonly they occur in the lining of the lungs or other internal organs. The occurrence of nodules in the lungs of miners exposed to silica dust was known as Caplan’s syndrome. [ 2 ]
The classic description of rheumatoid nodulosis in adults is that it is a variation of rheumatoid arthritis (RA) that appears as a proliferation of subcutaneous nodules, frequently on the hands and feet, linked to palindromic rheumatism without loss of joint function and with minimal to no systemic symptoms. [2]
Rheumatoid neutrophilic dermatitis occurs more frequently in patients with severe, persistent seropositive arthritis; it presents clinically as erythematous papules, nodules, plaques, or lesions resembling urticaria without any accompanying symptoms. [3] [4] [5] Less common conditions include annular lesions, blisters, ulcers, and vesicles.
A diagram showing how rheumatoid arthritis affects a joint Hand deformity, sometimes called a swan deformity, in an elderly person with rheumatoid arthritis. Arthritis of joints involves inflammation of the synovial membrane. Joints become swollen, tender and warm, and stiffness limits their movement.
Remitting seronegative symmetrical synovitis with pitting edema (or sometimes RS 3 PE) is a rare syndrome identified by symmetric polyarthritis, synovitis, acute pitting edema (swelling) of the back of the hands and/or feet, and a negative serum rheumatoid factor. [2]