Cutaneous Signs of Rheumatic Disease

Aka: Cutaneous Signs of Rheumatic Disease, Dermatologic Manifestations of Rheumatologic Disease, Rheumatologic Conditions Presenting with Rash, Skin Findings in Rheumatologic Disease

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II. Exam: Peri-articular rash

  1. Erythema over involved joint
    1. Gouty Arthritis
    2. Septic Arthritis
    3. Palindromic rheumatism
  2. Rash over knuckles (Gottron's Papules)
    1. Dermatomyositis
  3. Rash between joints
    1. Systemic Lupus Erythematosus

III. Exam: Generalized Rash

  1. Diffuse transient rash
    1. Reactive Arthritis in Viral Infection
    2. Drug Reaction
  2. Salmon-colored rash
    1. Still's Disease
  3. Purpura
    1. Henoch-Schonlein Purpura (occurs after Upper Respiratory Infection)
  4. Painless, non-pruritic maculopapular or vesicular rash
    1. Gonococcal Arthritis

IV. Exam: Localized pathognomonic rash

  1. Malar Rash
    1. Systemic Lupus Erythematosus (Butterfly-shaped facial rash)
    2. Parvovirus B19 (Slapped cheek appearance)
  2. Erythematous Plaques or Nail Pitting
    1. Psoriasis and Psoriatic Arthritis
  3. Erythematous rings on trunk (Erythema Marginatum)
    1. Acute Rheumatic Fever
  4. Heliotrope Rash
    1. Dermatomyositis
  5. Keratoderma Blennorrhagicum involving soles
    1. Reiter's Syndrome
    2. Psoriatic Arthritis
  6. Target lesion (Erythema Chronicum Migrans)
    1. Lyme Disease
  7. Midline spinal skin changes (e.g. dermal sinus, midline Lipoma, sacral dimple)
    1. See Cutaneous Signs of Dysraphism
  8. Neurocutaneous Syndrome (e.g. Cafe-Au-Lait Macule)
    1. See Neurofibromatosis

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