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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 nodules can vary in size from 2 mm to 5 cm and are usually rather firm to the touch. Quite often they are associated with synovial pockets or bursae. About 5% of people with rheumatoid arthritis have such nodules within two years of disease onset, and the cumulative prevalence is about 20–30%. [4]
While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors. [1] The underlying mechanism involves the body's immune system attacking the joints. [1] This results in inflammation and thickening of the joint capsule. [1] It also affects the underlying bone and cartilage. [1]
A diagram visualising the effect of rheumatoid arthritis on the joint. Rheumatoid arthritis is an autoimmune disorder characterised by the immune system's attack on healthy body cells, causing inflammation in multiple areas of the body. [29] In individuals with rheumatoid arthritis, the immune system specifically targets the synovium, a ...
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.
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.
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