title: Erythema elevatum diutinum complicated by rheumatoid arthritis.
abstract: A 53-year-old female developed erythema elevatum diutinum (EED) twelve years after the onset of rheumatoid arthritis. The arthritis had been well controlled for the last several years. Annular purpuric macules were characteristically complicated by common nodular and plaque lesions. Both leukocytoclastic vasculitis and fibrosis were observed in the macular lesions, indicating that the lesions were a manifestation of an early phase of EED. Both types of skin lesions disappeared with treatment with dapsone. They have not relapsed for two years after stopping the dapsone. The leukocytoclastic vasculitis was thought to have developed independently of the rheumatoid arthritis. She had noticed sicca symptoms two years before the appearance of EED, but she did not satisfy the diagnostic criteria for Sjögren's syndrome.
authors.affiliation: Department of Dermatology, Kochi Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nakajima
authors.forename: M
authors.initials: M
authors.lastname: Ikeda
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Kodama
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D003622:Dapsone / Q000627:therapeutic use*; D004890:Erythema / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D014657:Vasculitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003622:Dapsone; D011239:Prednisolone