Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory disorder that primarily affects the joints, but may exhibit extra-articular, including cutaneous, manifestations such as rheumatoid nodules, rheumatoid vasculitis, granulomatous skin disorders, and neutrophilic dermatoses. A large burden of cutaneous disease may be an indication of RA disease activity and the need for more aggressive treatment. Many of the therapeutic agents used to treat RA can also result in cutaneous adverse effects, which pose their own diagnostic and therapeutic challenges. Anti-TNFα agents, in particular, have a wide variety of adverse effects including psoraisiform eruptions, granulomatous conditions, and cutaneous connective tissue disorders. Herein we provide an update on the clinical presentations and management of RA-associated cutaneous findings as well as drug-induced cutaneous effects, with particular attention to the adverse effects of biologic disease-modifying agents.
MeSH terms
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Administration, Cutaneous
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Antirheumatic Agents / adverse effects
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Antirheumatic Agents / therapeutic use
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Arthritis, Rheumatoid / complications
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Arthritis, Rheumatoid / drug therapy*
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Arthritis, Rheumatoid / pathology*
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Biological Therapy / adverse effects*
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Dermatomyositis / etiology
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Dermatomyositis / pathology
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Drug Eruptions / etiology
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Drug Eruptions / pathology
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Humans
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Lichenoid Eruptions / etiology
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Lichenoid Eruptions / physiopathology
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Lupus Erythematosus, Cutaneous / etiology
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Lupus Erythematosus, Cutaneous / pathology
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Melanoma / etiology
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Melanoma / pathology
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Pyoderma Gangrenosum / etiology
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Pyoderma Gangrenosum / pathology
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Rheumatoid Nodule / pathology
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Rheumatoid Vasculitis / pathology
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Skin Diseases / etiology*
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Skin Diseases / pathology*
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Skin Neoplasms / etiology
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Skin Neoplasms / pathology
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Sweet Syndrome / etiology
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Sweet Syndrome / pathology
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
Substances
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Antirheumatic Agents
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TNF protein, human
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Tumor Necrosis Factor-alpha