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Individuals affected by RS3PE typically have repeated episodes of inflammation of the lining of their synovial joints and swelling of the end portion of the limbs. [8] The arms and hands are more commonly affected than the legs and feet. [8] Both sides are usually involved though RS3PE can affect only one side in certain cases. [8]
No specific test exists to diagnose polymyalgia rheumatica; many other diseases can cause inflammation and pain in muscles, but a few tests can help narrow down the cause of the pain. Limitation in shoulder motion or swelling of the joints in the wrists or hands, are noted by the doctor. [14]
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
Intermittent use of topical steroids for atopic dermatitis is safe and does not cause skin thinning. [6] [7] [8] Skin atrophy can occur with both prescription and over the counter steroids creams. [9] Low doses of prednisone by mouth can also result in skin atrophy.
Rarer causes which usually behave differently but may cause joint pains: [88] Sarcoidosis, amyloidosis, and Whipple's disease can also resemble RA. Hemochromatosis may cause hand joint arthritis. Acute rheumatic fever can be differentiated by a migratory pattern of joint involvement and evidence of antecedent streptococcal infection.
The duration of acute topical corticosteroid withdrawal is variable; the skin can take months to years to return to its original condition. [ 2 ] [ 10 ] The duration of steroid use may influence the recovery factor time, with the patients who used steroids for the longest reporting the slowest recovery.
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When topical steroid medication is lost, the skin experiences redness, burning, itching, hot skin, swelling, and/or oozing for a length of time. This is also called 'red skin syndrome' or 'topical steroid withdrawal' (TSW). After the withdrawal period is over the atopic dermatitis can cease or is less severe than it was before. [40]
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