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Cutaneous nodules in patients with rheumatoid arthritis: a case report and review of literatures

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Abstract

We report a case of 57-year-old Japanese woman with an overlap syndrome of both rheumatoid arthritis (RA) and autoimmune hepatitis, who developed multiple skin nodules. An extensive biopsies of the nodules revealed rheumatoid neutrophilic dermatitis, showing panniculitis without vasculitis, combining with granulomatous formation histopathologically. Since cutaneous nodules in patients with RA are very complex, differential diagnosis should be done according to disease activities, medications used, and pathological findings. We suggest that the differences in histopathological findings of cutaneous nodules in patients with RA depend on their immunological conditions based on disease activities including therapeutic effects.

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Acknowledgments

The authors would like to thank Kazuhiro Sugi, MD, Director, Division of Hepatology, Kumamoto Medical Center, National Hospital Organization, Kumamoto, Japan, for his useful advice on autoimmune hepatitis of the present case.

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Authors and Affiliations

  1. Department of Internal Medicine and Rheumatology, Kumamoto Center for Arthritis and Rheumatology, 1-15-7 Kuhonji, Kumamoto, 862-0976, Japan

    Tadashi Nakamura & Syu-ichi Higashi

  2. Department of Orthopaedics and Rheumatology, Kumamoto Center for Arthritis and Rheumatology, 1-15-7 Kuhonji, Kumamoto, 862-0976, Japan

    Kunihiko Tomoda & Michishi Tsukano

  3. Department of Clinical Pathology, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Ken-ichi Iyama

Authors
  1. Tadashi Nakamura
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  2. Syu-ichi Higashi
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  3. Kunihiko Tomoda
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  4. Michishi Tsukano
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  5. Ken-ichi Iyama
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Correspondence to Tadashi Nakamura.

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Nakamura, T., Higashi, Si., Tomoda, K. et al. Cutaneous nodules in patients with rheumatoid arthritis: a case report and review of literatures. Clin Rheumatol 30, 719–722 (2011). https://doi.org/10.1007/s10067-010-1602-4

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  • DOI: https://doi.org/10.1007/s10067-010-1602-4

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