title: Skin Signs of Rheumatoid Arthritis and its Therapy-Induced Cutaneous Side Effects.
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.
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 41 Avenue Louis Pasteur, Suite 319, Boston, MA, 02115, USA.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Cohen
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 41 Avenue Louis Pasteur, Suite 319, Boston, MA, 02115, USA.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Wright
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, 41 Avenue Louis Pasteur, Suite 319, Boston, MA, 02115, USA. jfmerola@bwh.harvard.edu.|Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. jfmerola@bwh.harvard.edu.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Merola
mesh_terms: D000279:Administration, Cutaneous; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*; D001691:Biological Therapy / Q000009:adverse effects*; D003882:Dermatomyositis / Q000209:etiology / Q000473:pathology; D003875:Drug Eruptions / Q000209:etiology / Q000473:pathology; D006801:Humans; D017512:Lichenoid Eruptions / Q000209:etiology / Q000503:physiopathology; D008178:Lupus Erythematosus, Cutaneous / Q000209:etiology / Q000473:pathology; D008545:Melanoma / Q000209:etiology / Q000473:pathology; D017511:Pyoderma Gangrenosum / Q000209:etiology / Q000473:pathology; D012218:Rheumatoid Nodule / Q000473:pathology; D056653:Rheumatoid Vasculitis / Q000473:pathology; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology*; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology; D016463:Sweet Syndrome / Q000209:etiology / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D018501:Antirheumatic Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha