Extra-articular manifestations of rheumatic disease - dermatological symptoms
Lesion and what it points to
- *In rheumatology the skin is the accessible biopsy site and the earliest diagnostic clue*
- Organised by the lesion, because that is how she will meet it:
| Lesion | Points to |
|---|---|
| Palpable purpura | Small-vessel vasculitis - IgA vasculitis, cryoglobulinaemia, ANCA-associated, drug |
| Erythema nodosum | Sarcoid, IBD, streptococcus, TB, drugs, pregnancy, Behcet |
| Livedo reticularis / racemosa | Antiphospholipid syndrome, PAN, cholesterol emboli, vasculitis |
| Digital ulcers, pitting scars | Systemic sclerosis, vasculitis, APS |
| Malar rash / discoid lesions | SLE |
| Heliotrope, Gottron papules | Dermatomyositis |
| Psoriasiform plaques + nail change | Psoriatic arthritis, reactive arthritis |
| Pyoderma gangrenosum | IBD, RA, myeloproliferative disease |
| Oral/genital ulceration | Behcet, SLE, reactive arthritis, IBD |
| Sclerodactyly, calcinosis, telangiectasia | Systemic sclerosis / CREST |
| Rheumatoid nodules | Seropositive RA |
| Erythema migrans | Lyme disease (travel history - not endemic in Australia) |
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