Rheumatoid Arthritis Rashes

Rheumatoid Arthritis Rashes: What is it?

Rheumatoid Arthritis (RA) Rashes are skin manifestations that can occur in individuals with RA, an autoimmune disorder primarily affecting the joints. These rashes may result from inflammation of blood vessels (vasculitis), medication side effects, or immune system activity.

An autoimmune condition known as Rheumatoid Arthritis (RA) occurs when the body’s immune system targets itself, causing inflammation of the joint’s protective membrane. As a result, minor to severe symptoms may appear.

The majority of symptoms are associated with joint issues. However, you might also have flare-ups, when your symptoms worsen. This could involve inflammatory rashes on the body.

Additional skin disorders linked to RA may include:

Rheumatoid neutrophilic dermatitis, pyoderma gangrenosum, and Sweet’s syndrome are neutrophilic dermatoses.

Urticaria: Hives, or urticaria, can appear.

Rare skin conditions: People with RA may occasionally experience uncommon skin reactions like erythema dictum.

Medication side effects: Drugs such as methotrexate (Otrexup, preservative-free; Xatmep; and Trexall) can cause periungual infarcts, which are tissue deaths in the nails caused by a lack of blood flow, and rheumatoid vasculitis (RV).

For RA-related rashes, there are usually therapies available.

RV can also occur in people with RA. RV is an uncommon condition experienced in just 1% to 5% of persons with RA.

Rheumatoid Arthritis Rashes: What causes them?

Flares are episodes that are common in people with RA. A flare is a sign that a person’s body is experiencing more illness activity.

They could experience additional symptoms, including fever, joint swelling, and exhaustion, during a flare-up. During a flare, an RA rash is more likely to appear.

One of RA’s complications is RV. It is caused by the immune system and the interaction of elevated blood levels of rheumatoid factor (RF) with blood vessels.

Small veins and arteries become inflamed as a result. Although it is uncommon, RV tends to happen to patients who have had severe RA for a long period, and it can be quite devastating. Ulcers and skin sores may result from this illness.

Symptoms of Rheumatoid Arthritis rash:

How does a rash from rheumatoid arthritis appear? Depending on the kind of rash, yes. The four skin disorders listed below are linked to RA and can manifest as rash-like symptoms. Usually, both sides of the body experience the symptoms.

Palmar erythema

Palmar erythema, or “red palms,” can result from a range of health issues. It affects roughly 60% of RA patients. It occurs when the hand’s tiny blood arteries dilate, bringing more blood to the surface.

Redness in both palms, which may spread to the fingers, is one of the symptoms. There may be a faint sensation of warmth along with the redness. Usually, palmar erythema doesn’t itch or hurt.

Pressing on the skin will cause the redness to go away. When you lift your hand, when you’re under stress, or when the temperature of the air changes, the intensity of the redness can also fluctuate.

Rheumatoid vasculitis

Usually, those who have had severe RA for at least ten years get this illness. Thanks to increasingly potent systemic treatments for RA, it is less prevalent than it formerly was.

Small and medium-sized blood capillaries narrow due to inflammation in rheumatoid vasculitis. This disrupts the skin’s blood flow. Rheumatoid vasculitis is more likely to occur in those who smoke.

Signs and symptoms include:

• Piles, sores, or spots surrounding the fingernails
• Pain, edema, and redness in the fingertips or fingers
• When larger blood vessels become irritated, it can cause a painful red rash, usually on the legs.
• Ulcers on the skin

The whole body is impacted by rheumatoid vasculitis, not only the skin. Additional symptoms and indicators include:

• Numbness and tingling in hands and feet
• Cough, shortness of breath
• Pain in the chest
• Pain in the abdomen

Rheumatoid neutrophilic dermatitis

Long-term RA is linked to a rare skin disorder called rheumatoid neutrophilic dermatitis. It typically manifests as a raised rash on both arms and/or legs that is red, blue, or purple. It may also show up on the torso or o single limb. Blisters or skin ulcers may develop in extreme cases of neutrophilic dermatitis.

Interstitial granulomatous dermatitis

Another uncommon skin ailment linked to inflammatory illnesses like RA is interstitial granulomatous dermatitis.
Usually on the back, chest, or abdomen, but occasionally on the limbs, it results in red or skin-colored lumps or patches. Over days or months, patches may vary in size or shape. Usually, this ailment doesn’t hurt. Some people can feel a slight burning or itchy sensation.

Diagnosis:

When someone has rheumatoid arthritis, not all of their rashes are caused by the disease. For example, shingles, psoriasis, and contact dermatitis are frequent causes of rashes. For a precise diagnosis, consult a board-certified dermatologist because rashes can be challenging to diagnose on your own.

Based on the rash’s appearance and symptoms, your doctor might be able to diagnose it. The provider might wish to do a skin biopsy in certain situations. The sole conclusive laboratory test for rheumatoid vasculitis is a biopsy.

Continue taking your RA medication until you consult your rheumatologist if you think it might be the source of your rash. To manage your RA and maintain the healthiest possible skin, your dermatologist and rheumatologist can collaborate.

What is the Treatment for Rheumatoid Arthritis Rashes?

The cause and intensity of an RA-related rash determine how it should be treated. A remedy that is effective for one kind of rash might not be effective for another.

Typically, the goals of treatment are to control pain and discomfort and avoid infection. Since rashes could indicate that your RA isn’t being adequately managed, it’s also critical that treatments focus on the underlying issue.

Acetaminophen (Tylenol) is a common over-the-counter (OTC) medicine that may help ease rash pain. Nonsteroidal anti-inflammatory medicines (NSAIDs) might be harmful to your organs, so avoid using them for RA rashes.

Avoidable drugs include:

• ibuprofen (Advil, Motrin IB, Nuprin)
• naproxen sodium (Aleve)
• Aspirin (Bayer, Bufferin, St. Joseph)

A doctor might also think about prescribing painkillers if your pain is severe. Due to their great potential for addiction, opioid painkillers are often only recommended for really severe pain.

Additionally, a doctor might prescribe corticosteroids to lessen rash inflammation, which could lessen uncomfortable symptoms.

However, long-term use of these medications is not advised. If the doctor is concerned that your rash could grow infected, they’re likely to prescribe either a topical or oral antibiotic or both.

When it comes to addressing the underlying problem, there are various pharmacological alternatives available:

Immunosuppressive medications

By lowering the immunological reactions that harm your joints, these medications treat RA. However, they also increase your risk of infections and diseases since they weaken your immune system.

Biologics and disease-modifying antirheumatic medications (DMARDs) are two categories of immunosuppressive medications. DMARDs can slow the course of RA by reducing inflammation. Biologics are injectable medications that lower inflammation by targeting particular immune cells.

For those with weakened immune systems, DMARDs and biologics are not advised.

If other immunosuppressive medications are ineffective, Janus-associated kinase (JAK) inhibitors are the next course of treatment. By altering genes and immune cell activity, they aid in the prevention of inflammation.

Rash treatment:

Different kinds of RA rashes have different therapies.

Corticosteroids, like prednisone, are typically used as the first line of treatment for RV. The underlying problem may also be treated with DMARDs, including methotrexate.

Topical steroids and antibiotics are used to treat interstitial granulomatous dermatitis.

Occasionally, a change in medicine causes a rash. If you experience any symptoms after switching drugs, you should consult a physician. However, unless your doctor specifically instructs you to do so, you should not stop taking your drugs.

Can a rheumatoid arthritis rash cause complications?

Beyond just a rash, RA can create other problems. Blood flow in veins and arteries can be impacted by vasculitis. Severe vasculitis episodes can lead to the following outcomes:

• Loss of sensation in the hands and feet as well as nerve numbness and tingling.
• Impacted blood supply to the limbs, which may result in gangrene in the toes or fingers.
• Systemic vasculitis can cause a heart attack or stroke by affecting blood flow to the heart or brain.

RV is uncommon, and the aforementioned problems are even less common. A rash, however, can be a sign that something more serious is about to happen. If you suffer from any RV symptoms, consult a physician.

How does the prognosis for those with rheumatoid arthritis rashes look?

There are no long-term fixes that can stop RA rashes from happening. To help you manage your disease, doctors may prescribe a mix of drugs. These therapies may lessen joint injury and inflammation.

People with RA should make every effort to have as healthy a lifestyle as they can. A person with RA may benefit from the following lifestyle choices:

• Getting enough sleep will help minimize joint inflammation and lessen the symptoms of weariness.
• Whenever feasible, engage in physical activity to improve joint mobility and develop strong, flexible muscles.
• Engaging in stress-reduction techniques including reading, walking, meditation, or other relaxation-promoting pursuits.
• Eating a diet high in fruits, vegetables, whole grains, and lean proteins. This can assist you in keeping your weight in check, which is crucial for maintaining joint health.

Summary

The autoimmune disease known as rheumatoid arthritis (RA) mostly affects your joints. However, rashes or other skin issues can be caused by RA and some of the drugs used to treat it. Once your inflammation is under control, your symptoms might improve.

If you believe that your skin issues are a result of your medicine, let your doctor know. The best method to reduce RA symptoms like rashes, nodules, or ulcers is to get treatment. To check if your skin issues improve, however, your doctor may change your dosage or prescribe an alternative medication.

FAQs

References

• Rheumatoid arthritis rash Diagnosis & Treatment | FL Dermatologists. (2022, April 1). Water’s Edge Dermatology. https://www.wederm.com/patient-library/rheumatoid-arthritis-rash/#top
• Crna, R. N. M. (2022, August 30). Rheumatoid arthritis rashes: pictures, symptoms, and more. Healthline. https://www.healthline.com/health/rheumatoid-arthritis/rashes#outlook
• What are rheumatoid nodules? Causes and treatments. (n.d.). WebMD. https://www.webmd.com/rheumatoid-arthritis/rheumatoid-nodules