Lichenoid Cutaneous Lupus Erythematosus Mimicking Acanthosis Nigricans The photos depict a 45-year-old woman who presented to the Lupus Clinic of the University of São Paulo, Brazil, with lesions closely resembling acanthosis nigricans on her neck (A and B). The lesions had been present for four months. The patient had lived with systemic lupus erythematosus (SLE)…
Information overload generated by the media, family, friends and colleagues is apparent today. Personal beliefs play an important role in how we filter and process the abundant information available and subsequently identify its utility in daily life. Regardless of professional specialty, individual beliefs underpin personal approaches to clinical care, research development and engagement with patients…
When my daughter was a second-year internal medicine resident at Massachusetts General Hospital, Boston, she called me excitedly one evening. “Dad,” she reported, “I think I saw the optic nerve for the first time today with an ophthalmoscope.” I suppose I should have shared her exuberance, except that when I went to medical school, a…
A 25-year-old Mexican American woman with a five-year history of systemic lupus erythematosus (SLE) presents with refractory, acute cutaneous lupus erythematosus (ACLE) and subacute cutaneous lupus erythematosus (SCLE) affecting the scalp, face and hands. Her serologic phenotype is characterized by elevated anti-nuclear, anti-double-stranded deoxyribonucleic acid (dsDNA), anti-ribonucleoprotein (RNP), anti-Smith and anti-SS-A (Ro) antibodies and chronically…
Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histopathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with underlying systemic…
Eosinophilic granulomatosis with polyangiitis (EGPA) is an anti-neutrophil cytoplasmic antibody-associated vasculitis typically characterized by asthma, peripheral eosinophilia and medium- to small-vessel necrotizing vasculitis. Cutaneous manifestations in EGPA are diverse. Palpable purpura is the most common presentation, but urticaria, erythematous macules and papules, livedo reticularis, digital necrosis and cutaneous nodules have also been described.1 Non-hemorrhagic bullae…
I wouldn’t normally look to professional basketball as a model for healthcare, but sometimes answers come from unexpected places. The observation that elite athletes are not like you and me—medically speaking—is not new. In the second century AD, the pontifex maximus in Pergamum recognized this fact and appointed Claudius Galen physician to the gladiators, making…
Because rheumatologists and mental health experts both treat patients with depression, anxiety, pain, disability and sleep disorders, provider cross-training may benefit patients and providers themselves. “When a patient has active psychosocial distress, this has a negative effect on their physical function. Similarly, if a patient has active physical symptoms, like a rheumatoid arthritis flare, this…
In a small preliminary study, the novel MK2 inhibitor, CC-99677, was safe and well tolerated by healthy participants. With daily dosing, the agent sustained reductions of tumor necrosis factor alpha and other cytokines for 14 days.
NEW YORK (Reuters Health)—In patients with rheumatoid arthritis (RA) refractory to treatment with rituximab or tocilizumab, genetic profiling of synovial biopsies predicted the lack of therapeutic response better than a model using only tissue pathology or clinical factors, researchers say.1 “We believe this study is a paradigm shift in precision medicine in RA,” Dr. Costantino…