What are the other Names for this Condition? (Also known as/Synonyms)

• Cutaneous Rheumatoid Nodules

What is Rheumatoid Nodules of Skin? (Definition/Background Information)

• Rheumatoid Nodules of Skin are slow-growing benign tumors that can occur anywhere in the body. They commonly occur in individuals with rheumatoid arthritis (RA, an autoimmune, inflammatory disorder). However, not all individuals with RA develop the condition
• The cause of Rheumatoid Nodules of Skin is generally unknown, even though the development of the condition is usually correlated with the severity of rheumatoid arthritis. Rheumatoid Nodules of Skin can also be influenced by the presence of other immune-related disorders such as systemic lupus erythematosus and scleroderma
• The nodules are generally firm, painless, and range in size from a few millimeters to several centimeters. Rheumatoid Nodules may be diagnosed through a physical examination and an association with RA (if present). A tissue biopsy may be performed to eliminate other similar conditions
• The treatment of Rheumatoid Nodules of Skin includes treating underlying conditions (autoimmune disorders) and surgical excision and removal of the tumors, if they present cosmetic issues or restrict the movement of joints. The prognosis is generally excellent with proper treatment

Who gets Rheumatoid Nodules of Skin? (Age and Sex Distribution)

• Rheumatoid Nodules of Skin mostly develop in adults with rheumatoid arthritis. However, it can develop in individuals of any age, including children
• It affects both males and females
• The condition occurs worldwide in all races and ethnic groups

Note: Not all individuals with RA develop Rheumatoid Nodules of Skin.

What are the Risk Factors for Rheumatoid Nodules of Skin? (Predisposing Factors)

The main risk factor for Rheumatoid Nodules of Skin is rheumatoid arthritis. Other risk factors for the condition may include autoimmune disorders such as:

• Systemic lupus erythematosus (SLE)
• Scleroderma
• Ankylosing spondylosis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Rheumatoid Nodules of Skin? (Etiology)

• The causative factors of Rheumatoid Nodules of Skin development are not well known or understood
• It occurs in individuals with rheumatoid arthritis (RA). However, studies have shown that only 1 in 4 individuals with RA develop Rheumatoid Nodules
• The development is usually correlated with the severity of RA. Individuals with high rheumatoid factor (RF) are at a higher risk
• It can be also influenced by the presence of SLE, scleroderma, and ankylosing spondylosis

What are the Signs and Symptoms of Rheumatoid Nodules of Skin?

The signs and symptoms of Rheumatoid Nodules of Skin may include:

• The presence of benign tumors that occur as multiple nodules below the skin (subcutaneous)
• They are slow-growing, firm, and painless. They may be occasionally painful
• The size of the nodules may range from 1-5 cm
• The nodules usually occur in soft tissues and joints; frequently in the elbows and fingers. However, Rheumatoid Nodules of Skin may appear at any location in the body
• Sometimes, the nodules can ulcerate and bleed, especially when subjected to  trauma

Additionally, the signs and symptoms of accompanying RA (or other conditions) may be observed.

How is Rheumatoid Nodules of Skin Diagnosed?

Rheumatoid Nodules of Skin is diagnosed using the following methods:

• A thorough physical examination correlated with a medical history of rheumatoid arthritis (or other autoimmune conditions)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: Cutaneous Rheumatoid Nodules are usually biopsied to rule out other tumors (benign or cancerous).

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Rheumatoid Nodules of Skin?

Rheumatoid Nodules of Skin may give rise to the following complications:

• Bleeding and ulceration may lead to the development of superimposed bacterial or fungal infections
• Decreased mobility and limitation of movements of the affected joint, if the tumor occurs near a joint
• It may result in cosmetic issues in some individuals depending upon the nodule location
• Rheumatoid nodules can also occur in other organs, such as the heart, lungs, and pleura (necrotizing granulomas may be observed in them, on  pathological examination)
• Other complications due to rheumatoid arthritis or other underlying disorders may be seen

How is Rheumatoid Nodules of Skin Treated?

The treatment measures available for Rheumatoid Nodules of Skin include:

• In some cases, the healthcare provider may recommend a ‘wait and watch’ approach and observe progress of the condition
• A complete surgical excision (an excisional open biopsy) is the preferred method of removal of the nodules. It may be performed if there are cosmetic issues, or if the tumors affect the free movement of joints
• Follow-up care with regular screening and check-ups are important and encouraged

The treatment measures for Rheumatoid Nodules of Skin will include undertaking a proper control of underlying rheumatoid arthritis, lupus, scleroderma, or ankylosing spondylosis.

How can Rheumatoid Nodules of Skin be Prevented?

• Rheumatoid arthritis does not always lead to Rheumatoid Nodules of Skin and not all individuals with longstanding autoimmune disorders may be affected by this benign condition. However, ensuring a proper control of RA (or other underlying conditions) may help prevent Rheumatoid Nodules of Skin
• If there is an early, aggressive, and proper treatment of this inflammatory disorder (RA), then the progression of Rheumatoid Nodules may be slowed down or decreased

What is the Prognosis of Rheumatoid Nodules of Skin? (Outcomes/Resolutions)

• The prognosis of Rheumatoid Nodules of Skin is generally excellent with adequate treatment
• However, the prognosis also depends upon the severity of underlying rheumatoid arthritis (or other conditions)
• Adequately treating the underlying condition (autoimmune disorder) can help control the size of the nodules and decrease the risk of formation of new nodules

Additional and Relevant Useful Information for Rheumatoid Nodules of Skin:

• Rheumatoid arthritis (RA) is a chronic auto-immune systemic inflammatory disorder that may affect the lining of joints, surrounding tissues, or organs within the body

The following link will help you understand rheumatoid arthritis better:

https://www.dovemed.com/diseases-conditions/rheumatoid-arthritis-ra/