Schneiderman Prelims Vol-I. qxd

ARTHRITIS AND RASH
AUTOIMMUNE DISEASES, AND DISEASES
OF IMMUNE DYSFUNCTION
Angioedema 
AD 134:929–931, 1998
Antineutrophil cytoplasmic antibody syndrome – polyarthritis,
purpuric vasculitis, orogenital ulceration, fingertip necrosis,
pyoderma gangrenosum-like ulcers 
BJD 134:924–928, 1996
Autoimmune progesterone dermatitis
AD 107:896, 1973
Bowel arthritis–dermatitis syndrome – pustular vasculitis,
erythema nodosum-like lesions; tenosynovitis, non-destructive
polyarthritis 
BJD 142:373–374, 2000; AD 135:1409–1414,
1999; Cutis 63:17–20, 1999; JAAD 14:792–796, 1986; Mayo
Clin Proc 59:43–46, 1984; AD 115:837–839, 1979
Common variable immunodeficiency 
BJD 144:597–600, 2001
Dermatomyositis – bursitis of shoulders and hips, joint effusions
Rook p.2558, 1998, Sixth Edition; Am J Med 67:287–292, 1979;
arthralgias 
JAAD 51:427–439, 2004
Fogo selvagem (endemic pemphigus) – arthralgias 
JID
107:68–75, 1996; JAAD 32:949–956, 1995
Hyper-IgE syndrome – hyperextensible joints 
Pediatr
141:572–575, 2002; Curr Prob Derm 10:41–92, 1998
Juvenile rheumatoid arthritis (Still’s disease) 
Med Chir Trans
80:47, 1897
Salmon pink macules, papules
Evanescent not migratory
With fever
Trunk, extremities; pressure areas
Usually non-pruritic
‘Resident’s rash’
Misinterpreted as drug rash
Koebner phenomenon
Fever, FUO
Quotidian – single or double
Wide diurnal swings
Hyperpyrexia to subnormal temperature
Urticaria 
Clin Rheumatol 19:389–391, 2000
Pharyngitis at presentation
Migratory arthritis becomes chronic
Lymphadenopathy
Leukocytosis, neutrophilic
Elevated erythrocyte sedimentation rate (ESR) (two-thirds
of patients with ESR of 100 or greater) 
Elevated liver function tests
Elevated ferritin
Linear IgA disease 
BJD 119:789–792, 1988
Lupus erythematosus – systemic; discoid lupus erythematosus
Rook p.2444–2449,2738, 1998, Sixth Edition; NEJM
269:1155–1161, 1963
Mixed connective tissue disease 
Rook p.2545, 1998, Sixth
Edition; Am J Med 52:148–159, 1972
Morphea 
Rook p.2507, 1998, Sixth Edition; pansclerotic
morphea – mutilating form of morphea 
AD 116:169–173, 1980;
generalized morphea 
Rook p.2511, 1998, Sixth Edition
Relapsing polychondritis
Auricular chondritis
Limited to cartilagenous portion of ears
Lobules spared
Redness may involve retroauricular soft tissues
Residual – permanent induration
– cauliflower ear
Nasal chondritis
Saddle nose deformity
Seronegative, non-destructive arthritis
Non-nodular, asymmetric
Rarely deformity
Polyarthralgia – mimicks rheumatoid arthritis
Costal cartilage
Sternoclavicular, manubrial-sternal joint
Rheumatoid arthritis-associated lesions 
Rook p.2566–2568,
1998, Sixth Edition
Rheumatoid neutrophilic dermatitis
Rheumatoid vasculitis
Dawson’s palms (palmar erythema) 
Yellow discoloration of skin
Skin transparency
Subcutaneous nodules
Sweet’s syndrome
Erythema elevatum diutinum
Pyoderma gangrenosum
Scleroderma – tenderness and swelling of joints as presenting
signs 
Rook p.2566,2738, 1998, Sixth Edition