Douglas K M J, Ladoyanni E, Treharne G J, Hale E D, Erb N, Kitas G D
Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley, West Midlands DY1 2HQ, UK.
Ann Rheum Dis. 2006 Oct;65(10):1341-5. doi: 10.1136/ard.2005.048934. Epub 2006 Feb 13.
Cutaneous abnormalities are common in rheumatoid arthritis, but exact prevalence estimates are yet to be established. Some abnormalities may be independent and coincidental, whereas others may relate to rheumatoid arthritis or its treatment.
To determine the exact nature and point prevalence of cutaneous abnormalities in patients with rheumatoid arthritis compared with those in patients with non-inflammatory rheumatic disease.
349 consecutive outpatients for rheumatology (205 with rheumatoid arthritis and 144 with non-inflammatory rheumatic conditions) were examined for skin and nail signs by a dermatologist. Histories of rheumatology, dermatology, drugs and allergy were noted in detail.
Skin abnormalities were reported by more patients with rheumatoid arthritis (61%) than non-inflammatory controls (47%). More patients with rheumatoid arthritis (39%) than controls (10%) attributed their skin abnormality to drugs. Cutaneous abnormalities observed by the dermatologist were also more common in patients with rheumatoid arthritis (76%) than in the group with non-inflammatory disease (60%). Specifically, bruising, athlete's foot, scars, rheumatoid nodules and vasculitic lesions were more common in patients with rheumatoid arthritis than in controls. The presence of bruising was predicted only by current steroid use. The presence of any other specific cutaneous abnormalities was not predicted by any of the variables assessed. In the whole group, current steroid use and having rheumatoid arthritis were the only important predictors of having any cutaneous abnormality.
Self-reported and observed cutaneous abnormalities are more common in patients with rheumatoid arthritis than in controls with non-inflammatory disease. These include cutaneous abnormalities related to side effects of drugs or to rheumatoid arthritis itself and other abnormalities previously believed to be independent but which may be of clinical importance.
皮肤异常在类风湿关节炎中很常见，但确切的患病率估计尚未确定。一些异常可能是独立且偶然的，而其他异常可能与类风湿关节炎或其治疗有关。
确定类风湿关节炎患者与非炎性风湿性疾病患者相比，皮肤异常的确切性质和现患率。
由一名皮肤科医生对349名连续就诊的风湿病门诊患者（205名类风湿关节炎患者和144名非炎性风湿性疾病患者）进行皮肤和指甲体征检查。详细记录风湿病、皮肤病、用药和过敏史。
报告有皮肤异常的类风湿关节炎患者（61%）多于非炎性对照组（47%）。将皮肤异常归因于药物的类风湿关节炎患者（39%）多于对照组（10%）。皮肤科医生观察到的皮肤异常在类风湿关节炎患者中（76%）也比非炎性疾病组（60%）更常见。具体而言，瘀伤、足癣、瘢痕、类风湿结节和血管病变在类风湿关节炎患者中比对照组更常见。瘀伤的出现仅由当前使用类固醇药物预测。其他任何特定皮肤异常的出现均未由所评估的任何变量预测。在整个研究组中，当前使用类固醇药物和患有类风湿关节炎是出现任何皮肤异常的仅有的重要预测因素。
自我报告和观察到的皮肤异常在类风湿关节炎患者中比非炎性疾病对照组更常见。这些包括与药物副作用或类风湿关节炎本身相关的皮肤异常，以及其他以前被认为是独立的但可能具有临床意义的异常。
