Sunil Gupta; Jaspriya Sandhu; Palvi Singla; Aditi Bansal; Bhavna Garg; Harpreet Kaur
Abstract
Rheumatoid vasculitis, an uncommon extraarticular manifestationof rheumatoid arthritis, usually develops in long-standing casesaffecting small-to-medium-sized vessels. It is a poor prognosticmarker when multiple systems are affected, skin and neurologicinvolvement being most frequent. Rheumatoid vasculitis ...
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Rheumatoid vasculitis, an uncommon extraarticular manifestationof rheumatoid arthritis, usually develops in long-standing casesaffecting small-to-medium-sized vessels. It is a poor prognosticmarker when multiple systems are affected, skin and neurologicinvolvement being most frequent. Rheumatoid vasculitis is seenmore commonly in seropositive and nodular rheumatoid arthritispatients who are male or smoke. Herein, we present the peculiarcase of a 48-year-old female with rapid onset, progressive, multipleulcers predominantly over the flexures. Differential diagnoses ofpyoderma gangrenosum, pyoderma vegetans, pemphigus vegetans,and vasculitis were considered, and the patient was evaluated. Oninvestigation, her rheumatoid factor titer was strongly positive;a skin biopsy revealed leukocytoclastic vasculitis. On clinical,serological, and histopathological correlation, a diagnosis ofrheumatoid vasculitis was made, responding well to high-doseprednisolone. On follow-up at six months, her skin lesions hadhealed well with moderate scarring; however, she developedsevere joint pain, warranting the initiation of disease-modifyingantirheumatic drugs. To the best of our knowledge, this is apreviously unreported clinical and morphological presentationof rheumatoid vasculitis.