Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Aug 1998
Case ReportsAccelerated cutaneous nodulosis during methotrexate therapy in a patient with rheumatoid arthritis.
Rheumatoid nodulosis is characterized by multiple small subcutaneous granulomatous nodules typically located on the elbows in approximately 20% of patients with rheumatoid arthritis. Accelerated rheumatoid nodulosis, especially involving the hands and feet, has recently been reported in patients receiving methotrexate therapy for rheumatoid arthritis. We describe a woman with seropositive, erosive rheumatoid arthritis who, on two occasions, developed nonperiarticular subcutaneous nodules and new heart murmurs during methotrexate therapy, while her arthritis remained under good control. ⋯ They again resolved after methotrexate was stopped and colchicine was added. Her DNA oligotyping was positive for HLA-DRB1*0401, a genetic risk factor associated with accelerated rheumatoid nodulosis. Cutaneous biopsy specimens revealed palisading granulomas and giant cells consistent with rheumatoid nodulosis.
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J. Am. Acad. Dermatol. · Aug 1998
Chronic neuropathic symptoms after exposure to mustard gas: a long-term investigation.
Long-term investigations of persons exposed to mustard gas are few and have primarily focused on its carcinogenic properties. To our knowledge neuropathic pain has never been described. ⋯ Persistent damage to the afferent nerve system resulting in chronic neuropathic symptoms is probably a frequent complication in persons exposed to mustard gas.