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Rheumatoid Nodules and Rheumatoid Arthritis: What Do These Little Skin Bumps Say About Your Internal Health?
Rheumatoid nodules are small bumps that appear on the surface of the skin, usually in places such as the tip of the ulna at the elbow or the joints of the fingers, although they can appear in other areas as well. Studies have shown that rheumatoid nodules are almost exclusively associated with rheumatoid arthritis, and their types include subcutaneous rheumatoid nodules, cardiac nodules, pulmonary nodules, and central nervous system nodules. Most of the time these nodules do not cause pain or functional impairment, but they may become painful due to infection. Therefore, it is important to understand the potential impact of these nodules on your health.
Rheumatoid nodules occur in approximately 5% of patients with rheumatoid arthritis, and their cumulative prevalence ranges from 20% to 30%.
Pathophysiology of rheumatoid nodules
Although the exact mechanism of rheumatoid nodule formation is still unclear, there are several hypotheses that the formation of these nodules is related to local inflammatory responses. Studies have shown that rheumatoid nodules usually form in areas exposed to external injuries, which means that the trauma leads to an inflammatory response, causing vascular inflammation and necrosis in the area. This process involves the activation of T cells, B cells and monocytes, which further leads to the formation of new blood vessels, which is a hallmark of rheumatoid arthritis.
The cause of rheumatoid arthritis has not been determined, but genetic and environmental factors are thought to influence its development.
Risk Factors for Rheumatoid Nodules
While not all people with RA will develop rheumatoid nodules, some risk factors increase the chances of these nodules forming. Among them, smoking, increased serum rheumatoid factor and trauma to small blood vessels are considered to be the main influencing factors. Patients who take medications such as methotrexate may also be at higher risk.
Diagnostic Process
The diagnosis of rheumatoid nodules is usually made by a rheumatologist and is differentiated based on the location of the nodules, deep pathology, age of onset, and concomitant joint diseases. Subcutaneous nodules at the site of stretched tendons are the most common presentation in patients with rheumatoid arthritis. The pathological features of these nodules usually show central necrosis and perivascular infiltration of mononuclear cells.
Distribution and types of rheumatoid nodules
According to statistics, subcutaneous rheumatoid nodules are the most common type, present in approximately 7% of rheumatoid arthritis patients when they are first diagnosed. In addition, these nodules increase the risk of cardiovascular and respiratory diseases, so cardiovascular and respiratory evaluation of these patients is particularly important. On the other hand, cardiac nodules and pulmonary nodules also exist, but their incidence is relatively low, and most research reports show that the appearance of such nodules is related to the severity of rheumatoid arthritis.
Precautions
It is still not possible to completely prevent the formation of rheumatoid nodules, but for patients who have been diagnosed with rheumatoid arthritis, proper disease management can help reduce the formation of nodules. Effective medication, quitting smoking, increasing exercise, and seeing a doctor regularly are all good habits that promote health.
Treatment Options
Treating rheumatoid nodules can be challenging because some medications used for rheumatoid arthritis may not be effective against the nodules. Topical steroid injections are considered one of the most effective options for treating rheumatoid nodules currently, and surgical excision is usually only considered in cases of skin necrosis or erosion.
As research on rheumatoid nodules and related diseases continues to deepen, more effective treatment strategies may be provided in the future. However, these seemingly insignificant small lumps of skin may reflect deeper health problems inside your body. Have you ever thought about the health signals these nodules convey?
