Tumoral Calcinosis in Systemic Sclerosis Plain radiograph and computed tomography images depict calcinosis in the region of the right shoulder, left elbow and cervical spine of a 71-year-old woman with a 20-year history of systemic sclerosis. Manifestations include high-titer anti-Scl-70 antibody, diffuse skin involvement, Raynaud’s syndrome, acro-osteolysis, gastroesophageal reflux disease, interstitial lung disease and complete…
Tongue Twister 12-year-old girl who had been diagnosed with Moebius syndrome a year earlier presented for evaluation of progressive tongue hemiatrophy that was causing her difficulty with eating and speaking. Magnetic resonance imaging (MRI) of the brain demonstrated tongue hemiatrophy without involvement of the hypoglossal nerve. A tongue biopsy showed atrophy of skeletal muscle, variably…
Saddle Nose & Cauliflower Ear Deformities in Relapsing Polychondritis These images depict a 32-year-old man who presented with five weeks of left-sided hearing loss, weight loss and discomfort in the nose, ear, chest wall and knee. He had an erythrocyte sedimentation rate (ESR) of 120 mm/hr, and a C-reactive protein level of 225.4 mg/L. The…
Featured Image from Europe & Central Asia Rheumatic Diseases of Childhood: Scleroderma These images depict a patient with a clinical presentation of juvenile dermatomyositis with typical skin manifestations of Gottron’s papules over the extensor surfaces of the joints, as well as hyperpigmentation. Yulia Vyzhga, MD, PhD, is a pediatric rheumatologist at National Pirogov Memorial Medical…
Rheumatic Diseases of Childhood: Juvenile Dermatomyositis with Calcinosis Cutis These images depict a 14-year-old boy with a two-year history of proximal muscle weakness affecting both upper and lower limbs, and a skin rash affecting his face. He was diagnosed with juvenile dermatomyositis and developed calcinosis over both legs with skin infection and ulceration. Plain X-ray…
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)…
Erosive Polyarticular Chronic Tophaceous Gout in a Young Man A 27-year-old man was referred to us for joint pain and nodular swelling over multiple joints. His symptoms started when he was 13 years old, but he was sub-optimally treated. On examination, we found marked digital deformity, with multiple large tophi over the small joints of…
People’s Choice: Keratoderma Blennorrhagica Submitted by Kunal Chandwar, MD, MBBS, King George’s Medical University, Lucknow, India, the photo depicts extensive keratoderma blennorrhagica in a patient with reactive arthritis. Spondyloarthropathies An 18-year-old man presented with psoriasiform plaque-like lesions that began on the limbs and progressed to involve his entire body (including his face) over a month….
Best Overall: Cutaneous Manifestations of Dermatomyositis These images, submitted by Santhanam Lakshminarayanan, MD, associate professor of medicine in the Division of Rheumatology the University of Connecticut School of Medicine, Farmington, show a 32-year-old Black woman with classic cutaneous manifestations of dermatomyositis: heliotrope rash; periorbital edema with complete closure of the eyes; erythema nodosum on the…
As part of the ACR’s pledge to be a leader for inclusion and change for members, trainees, staff and rheumatology patients, the ACR is holding a special image competition in conjunction with ACR Convergence 2021 dedicated exclusively to images of rheumatic disease in skin of color. “We started discussing the lack of diversity in our…