Cutaneous manifestations of rheumatoid arthritis: An observational study from a Tertiary Care Hospital in Eastern India

Background: Rheumatoid arthritis (RA) has both articular and extra-articular manifestations, with certain dermatoses occurring in increased frequencies in this population. Since clinicodemographic profile varies according to ethnicity and geographic location, the present study was conducted to record the dermatological presentations of RA in Eastern Indian population. Materials and Methods: This was an observational cross-sectional study conducted in a tertiary care hospital in Eastern India on adult patients of either sex attending the department of Dermatology. Consecutive patients were recruited and detailed clinicodemographic profile was recorded in a pretested, semi-structured pro forma. Results: Three hundred and twenty-four consecutive patients with a female predominance (M: F = 1:3.3) who fulfilled the eligibility criteria were recruited. Thirty-six patients had more than one cutaneous manifestation. Three hundred and sixty-two dermatological manifestations were noted with 57 (15.7%) having specific findings, 14 therapy-related adverse effects and 291 (80.4%) nonspecific findings. Vascular changes were commonest (22; 6.1%) followed by rheumatoid nodules (3.3%) and leg ulceration (2.8%). Rheumatoid factor was found positive in 233 (71.9%) cases and anti-citrullinated peptide antibody (ACPA) was positive in 250 (77.2%) cases. There was statistically no significant association between specific dermatological manifestations and age, duration, and family history of RA, rheumatoid factor, and ACPA positivity. Conclusion: Awareness and recognition of various skin manifestations is essential for a concerted therapeutic approach to patients with RA.