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Skin symptoms may indicate more serious rheumatic disease

Skin signs may be the first indicator of potential rheumatic disease, according to a release from the University of Texas Southwestern Medical Center in Dallas.


Dr. Kathryn Dao, an Associate Professor of Internal Medicine in the Division of Rheumatic Diseases at UT Southwestern, reports it is essential that physicians recognize these signs.

“Skin lesions can occur at any time,” she said in a news release from UT Southwestern. “If they are associated with an autoimmune disease, they will manifest when the disease is active. When autoimmune diseases are treated, the skin lesions will usually improve.”

Dr. Dao noted that certain skin signs may be more indicative of potential rheumatology issues, including:

  • Photosensitivity, which could potentially be an early symptom of systemic lupus erythematosus (SLE) or dermatomyositis. In patients with SLE, sun exposure might produce rashes on the bridge of the nose and cheekbones. With dermatomyositis, redness and itching might appear over the scalp, chest, neck, eyelids, hands, arms, and other areas of sun exposure. Thickened, red plaques may also develop on the knuckles. Patients should be advised to wear sun protection, including wearing hats, long-sleeved shirts, and pants.

  • Red, raised, scaly, silvery, and itchy skin lesions may be caused by psoriasis. These patches are most common on the scalp, elbows, and knees, but lesions might also appear on the face, armpits, back, belly button, groin, and buttocks. Scratching could produce more lesions.

  • Raynaud’s phenomenon is marked by poor blood flow that causes white, purple, or red colouring on the extremities.

  • Large, red nodules characterized by the patient as painful could be indicative of erythema nodosum, caused by inflammation of the fatty layer of skin and are often located on the legs. Causes include infection, a drug reaction, pregnancy, or autoimmune disease.

Dr. Dao stressed that patients should always be advised to avoid scratching skin lesions, which may worsen or cause an infection. Sun protection and regular skin checks are also encouraged, she said.

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