This in a patient with rheumtoid arthritis.
RHEUMATOID VASCULITIS
Rheumatoid Vasculitis (RV) is a necrotizing vasculitis of medium-size vessels occuring in a patient with rheumatoid arthritis.
- 90% of patients with RV have skin involvement, the most common being deep ulcers about the ankles.
- RV is more frequent in the patients with severe RA of longer duration and anti-CCP positivity.
- The rheumatoid factor is typically high.
Clinical
Deep cutaneous ulcers are most typical. Cutaneous features may range from in indolent skin disease (e.g. nail fold infarcts, petechia and livedo reticularis) to a life-threatening multiorgan vasculitis resembling polyarteritis nodosa (e.g. with necrotic ulcers, digital gangrene and mononeuritis multiplex).
Treatment
Referral to a rheumatologist is in order.
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