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CASE REPORT
Year : 1997  |  Volume : 63  |  Issue : 2  |  Page : 109-110

Neurofibroma occurring in patients with rheumatoid arthritis




Correspondence Address:
V G Prabhakara


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Source of Support: None, Conflict of Interest: None


PMID: 20944289

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  Abstract 

Two female patients suffering from rheumatoid arthritis presented with the complaint of papular skin lesions over the dorsal aspect of hands. Histopathological examination of papules showed the features of neurofibroma.


Keywords: Neurofibroma, Rheumatoid arthritis


How to cite this article:
Prabhakara V G, Jayaraman M, Kamalam A, Yesudian P a. Neurofibroma occurring in patients with rheumatoid arthritis. Indian J Dermatol Venereol Leprol 1997;63:109-10

How to cite this URL:
Prabhakara V G, Jayaraman M, Kamalam A, Yesudian P a. Neurofibroma occurring in patients with rheumatoid arthritis. Indian J Dermatol Venereol Leprol [serial online] 1997 [cited 2019 Jun 19];63:109-10. Available from: http://www.ijdvl.com/text.asp?1997/63/2/109/4532



  Introduction Top


Rheumatoid arthritis (RA) is a chronic disorder involving predominantly smaller joints of the hands and feet.[1] Neurofibromatosis (NF) is an autosomal dominant inherited disorder.[2][3]Skin manifestations in RA include non-specific, specific, associated disorders and those due to the drugs used in the treatment of RA. [3,4]


  Case Reports Top


Case 1. In December 1992, a 55-year-old female, having rhematoid arthritis for more than 20 years, presented with the complaint of papular skin lesions over the dorsal aspect of the hands of 3 years duration. The papules were gradually increasing in size and number. She was receiving brufen (400mg 1tds) and Dpenicillamine (200mg 1bd). On examination she had multiple, discrete, skin coloured, grouped papules over the dorsal aspect of the hands. Skin biopsy of one of the papules was performed. To our surprise, the H&E section showed young wavy collagen suggesting the diagnosis of neurofibroma (NF).

Case 2. In May 1993, a 48-year-old female, known patient of RA for more than 20 years, presented with the complaint of papular skin lesions over the dorsal aspect of the left hand. The papules were gradually increasing in size. She was receiving brufen (400mg 1tds) and D-penicillamine (200mg 1bd). On examination she had 2 discrete skin coloured papules over the dorsal aspect of the left hand. Alerted by our previous experience one of the papules was biopsied which showed features of NF.


  Discussion Top


There are various disorders associated with RA like scleredema of Buschke, hereditary angio-oedema, rheumatoid neutrophilic dermatitis, pustulosis palmoplantaris, melanoma, lymphoma, squamous cell carcinoma and others.[4][5][6] There have been no earlier reports of NF occurring in RA patients. At present, there is no established direct link between RA and NF. Further observations and studies may reveal a possible link between RA and NF[Figure - 1][Figure - 2].

 
  References Top

1.Peter E Lipsky PE. Rheumatoid arthritis. In: Harrison's principles of Internal Medicine. New York: McGraw Hill, 1991;1437-43.  Back to cited text no. 1    
2.Cotran RS, Kumar V, Robbins SL. The musculoskeletal system and genetic disorders. In: Robbins pathologic basis of disease. 4th edition. New York: W B Saunders, 1989:1349-54.  Back to cited text no. 2    
3.Rowell NR, Goodfield MJD. The connective tissue diseases. In: Textbook of dermatology. London: Blackwell,1992:2286-93.  Back to cited text no. 3    
4.Macki RM, Helen M, Nelson HM, Dick DC, et al. Dermatological manifestations of connective tissue disease. Recent Advan Rheumatol 1981;2:53-64.  Back to cited text no. 4    
5.Sibbitt WL jr, Williams RC Jr. Cutaneous manifestations of rheumatoid arthritis. Int J Dermatol 1982:21:563-72.  Back to cited text no. 5  [PUBMED]  
6.Jorizzo JL, Daniels J C. Dermatologic conditions reported in patients with rheumatoid arthritis. J Am Acad Dermatol 1983:8:439-57.  Back to cited text no. 6    


    Figures

[Figure - 1], [Figure - 2]



 

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