Skin manifestations of rheumatoid arthritis: a study of 215 Turkish patients
Identifieur interne : 001963 ( Main/Exploration ); précédent : 001962; suivant : 001964Skin manifestations of rheumatoid arthritis: a study of 215 Turkish patients
Auteurs : Tulin Ergun [Turquie] ; Nevsun Inanc [Turquie] ; Davut Tuney [Turquie] ; Esin Karaa Kotiloglu [Turquie] ; Dilek Seckin [Turquie] ; Cihangir Tetik [Turquie] ; Haner Direskeneli [Turquie]Source :
- International Journal of Dermatology [ 0011-9059 ] ; 2008-09.
Abstract
Objective To investigate the frequency and clinicopathological features of skin involvement in rheumatoid arthritis (RA), to find out whether early and aggressive disease‐modifying treatment is changing the spectrum towards a milder disease pattern. Methods Two hundred and fifteen consecutive RA patients were enrolled. Main outcome measures were the frequency of cutaneous features and their relation to disease severity and treatment modality, ultrasound (USG) examination of nodules, histopathological examination of nodules and papules. Results Mean age and disease duration were 55.3 years and 138.1 months, respectively. Sixty‐six percent of the patients had erosive disease, 70% were rheumatoid factor (RF) positive and 44% had Classes III and IV functional index. Among 43 patients having nodules, 20 were diagnosed as rheumatoid nodules (RNs) and the others as synovitis, bursitis, and so on, on clinical basis and by ultrasound. In 7 of 20 RNs, diagnosis was confirmed by histopathological examination. When clinical, histopathological, and USG data were analyzed collectively, sensitivity, and specifity of USG were found as 100 and 75%, respectively. Sixteen patients had relevant papular lesions. Fourteen of these were diagnosed as palisading neutrophilic granulomatous dermatitis (PNGD) and two as rheumatoid neutrophilic dermatitis (RND) on histopathological examination. Accelerated nodulosis was seen in one, and vasculitis in two of the patients. Conclusions We observed a milder disease pattern compared to Anglo‐Saxon countries with lower RN and vasculitis frequency. This cannot be explained by early and aggressive treatment as disease onset to treatment interval was long in our patient group. PNGD resembles RN in terms of frequency and association with severe disease.
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DOI: 10.1111/j.1365-4632.2008.03708.x
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Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Tuney, Davut" sort="Tuney, Davut" uniqKey="Tuney D" first="Davut" last="Tuney">Davut Tuney</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>From the Departments of Dermatology, Rheumatology, Radiology, Pathology, and Orthopaedic Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Kotiloglu, Esin Karaa" sort="Kotiloglu, Esin Karaa" uniqKey="Kotiloglu E" first="Esin Karaa" last="Kotiloglu">Esin Karaa Kotiloglu</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>From the Departments of Dermatology, Rheumatology, Radiology, Pathology, and Orthopaedic Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Seckin, Dilek" sort="Seckin, Dilek" uniqKey="Seckin D" first="Dilek" last="Seckin">Dilek Seckin</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>From the Departments of Dermatology, Rheumatology, Radiology, Pathology, and Orthopaedic Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Tetik, Cihangir" sort="Tetik, Cihangir" uniqKey="Tetik C" first="Cihangir" last="Tetik">Cihangir Tetik</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>From the Departments of Dermatology, Rheumatology, Radiology, Pathology, and Orthopaedic Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Direskeneli, Haner" sort="Direskeneli, Haner" uniqKey="Direskeneli H" first="Haner" last="Direskeneli">Haner Direskeneli</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>From the Departments of Dermatology, Rheumatology, Radiology, Pathology, and Orthopaedic Surgery, Marmara University School of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">International Journal of Dermatology</title><title level="j" type="alt">INTERNATIONAL JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0011-9059</idno><idno type="eISSN">1365-4632</idno><imprint><biblScope unit="vol">47</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="894">894</biblScope><biblScope unit="page" to="902">902</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2008-09">2008-09</date></imprint><idno type="ISSN">0011-9059</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0011-9059</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To investigate the frequency and clinicopathological features of skin involvement in rheumatoid arthritis (RA), to find out whether early and aggressive disease‐modifying treatment is changing the spectrum towards a milder disease pattern. Methods Two hundred and fifteen consecutive RA patients were enrolled. Main outcome measures were the frequency of cutaneous features and their relation to disease severity and treatment modality, ultrasound (USG) examination of nodules, histopathological examination of nodules and papules. Results Mean age and disease duration were 55.3 years and 138.1 months, respectively. Sixty‐six percent of the patients had erosive disease, 70% were rheumatoid factor (RF) positive and 44% had Classes III and IV functional index. Among 43 patients having nodules, 20 were diagnosed as rheumatoid nodules (RNs) and the others as synovitis, bursitis, and so on, on clinical basis and by ultrasound. In 7 of 20 RNs, diagnosis was confirmed by histopathological examination. When clinical, histopathological, and USG data were analyzed collectively, sensitivity, and specifity of USG were found as 100 and 75%, respectively. Sixteen patients had relevant papular lesions. Fourteen of these were diagnosed as palisading neutrophilic granulomatous dermatitis (PNGD) and two as rheumatoid neutrophilic dermatitis (RND) on histopathological examination. Accelerated nodulosis was seen in one, and vasculitis in two of the patients. Conclusions We observed a milder disease pattern compared to Anglo‐Saxon countries with lower RN and vasculitis frequency. This cannot be explained by early and aggressive treatment as disease onset to treatment interval was long in our patient group. PNGD resembles RN in terms of frequency and association with severe disease.</div></front></TEI><affiliations><list><country><li>Turquie</li></country></list><tree><country name="Turquie"><noRegion><name sortKey="Ergun, Tulin" sort="Ergun, Tulin" uniqKey="Ergun T" first="Tulin" last="Ergun">Tulin Ergun</name></noRegion><name sortKey="Direskeneli, Haner" sort="Direskeneli, Haner" uniqKey="Direskeneli H" first="Haner" last="Direskeneli">Haner Direskeneli</name><name sortKey="Inanc, Nevsun" sort="Inanc, Nevsun" uniqKey="Inanc N" first="Nevsun" last="Inanc">Nevsun Inanc</name><name sortKey="Kotiloglu, Esin Karaa" sort="Kotiloglu, Esin Karaa" uniqKey="Kotiloglu E" first="Esin Karaa" last="Kotiloglu">Esin Karaa Kotiloglu</name><name sortKey="Seckin, Dilek" sort="Seckin, Dilek" uniqKey="Seckin D" first="Dilek" last="Seckin">Dilek Seckin</name><name sortKey="Tetik, Cihangir" sort="Tetik, Cihangir" uniqKey="Tetik C" first="Cihangir" last="Tetik">Cihangir Tetik</name><name sortKey="Tuney, Davut" sort="Tuney, Davut" uniqKey="Tuney D" first="Davut" last="Tuney">Davut Tuney</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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