A study of dermatological manifestations in patients attending the rheumatology outpatient department at a tertiary care hospital

Abstract

Background: Autoimmune processes commonly involve skin along with the musculoskeletal system, resulting in inflammatory diseases characterized by concurrent mucocutaneous and rheumatic manifestations. Aim: We undertook a clinical study to assess the pattern, type, extent, severity, and morphology of dermatological manifestations in rheumatology patients, to analyze the correlation of dermatoses observed with the type of rheumatological disorder, and to look for the side effects of drug therapy including disease-modifying antirheumatic drugs. Materials and Methods: A cross-sectional descriptive study carried out in the outpatient department (OPD) setting of 100 patients, having joint and/or bone involvement associated with cutaneous disorders, attending rheumatology OPD of a tertiary care hospital were included and followed up for 6 months to assess the mucocutaneous manifestations. Patients with no cutaneous manifestations were excluded from the study. Statistical analysis was done using STATA 13 IC. Results: Papulosquamous skin lesions (45%) were the most common dermatological manifestations in the study, followed by nail changes (30%), photosensitivity (20%), Raynaud's phenomenon (17%), and malar rash (15%). Drug-induced cutaneous features were seen in 18% of patients. Cutaneous manifestations were seen most commonly in the connective tissue diseases group (55%), followed by seronegative arthritis (34%), rheumatoid arthritis (8%), and erythema nodosum (3%). Frequently affected age group was 31–40 years (41%), followed by 41–50 years (23%) of age group. The most common therapeutic interventions causing cutaneous side effects were systemic steroids. Conclusions: Many patients attending the rheumatology OPD present with varied mucocutaneous manifestations, and they can also develop numerous drug-related cutaneous side effects once started on antirheumatic medications. Hence, a collaborative clinic between a rheumatologist and a dermatologist is a necessity which will help in holistic patient management and disease remission.

Keywords

• Antirheumatic drugs
• connective tissue disorders
• mucocutaneous lesions
• mucocutaneous side effects
• psoriatic arthritis
• rheumatology outpatient department