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Skin Conditions Associated with Joint Pain

Rash
	• Human parvovirus B19 infection

Malar rash
	• SLE
	• Human parvovirus B19 infection
	•
Skin Conditions ... Scleroderma Thickened skin ... arthritis Discoid skin ... #joint #pain #skin ... #rashes #differential
Leg Pain - Differential Diagnosis Framework

Bone/Joint Causes of Leg Pain:
 • Fracture
 • Arthritis
 • Gout/pseudogout
thrombophlebitis Skin ... band syndrome • Shin ... Brittle nails - Skin ... skin • Inflammation ... lower #extremity #msk
Joint Disorders - Differential Diagnosis Algorithm
Monoarthritis
 • Septic
 • Crystalline
     - Gout
within 1 month of infection ... arthritis - with the skin ... should have other symptoms ... like “butterfly rash ... Joint #Disorders #msk
Adult Onset Still's Disease - Yamaguchi Criteria
Major criteria:
 - Fever >= 39C lasting >= 1 weeks
weeks - Typical skin ... rash: maculopapular ... non-pruritic, salmon-pink rash ... criteria: - Infection ... #Major #Minor #Rheumatology
Systemic Sclerosis (Scleroderma)
Multi-system autoimmune disease characterized by vasculopathy and progressive fibrosis of skin and internal organs
3
LcSSc) - distal skin ... DcSSc; diffuse) - skin ... salt and pepper" skin ... changes): skin ... Scleroderma #SSc #rheumatology
Adult-Onset Still's Disease
Clinical triad: Fever, Arthralgia/arthritis, Skin rash ± odynophagia
+ Biological inflammation: Increased neutrophils, Hyperferritinemia, decreased
Arthralgia/arthritis, Skin ... rash ± odynophagia ... fraction < 20% Differential ... Diaqnoses: • Infectious ... management #treatment #rheumatology
Dermatologic Manifestations of Granulomatosis with Polyangiitis (GPA)

Skin involvement in granulomatosis with polyangiitis (GPA) is common and
Polyangiitis (GPA) Skin ... vasculitis Skin ... also occur Skin ... 16%) • Painful skin ... Skin Biopsy
Lymphocutaneous Sporotrichiosis Infection

Landscaper w/ painless nodular rash of arm present for months wax and wane; diagnosis?
Lymphocutaneous
painless nodular rash ... trauma leads to skin ... painless, no systemic signs ... biopsy preferred Differential ... Diseases Fellowship
Clinical Features of Systemic Lupus (SLE)
General: Fever (50%), Depression, Fatigue (75%), Weight loss (50%)
Eye: Sjögrens (15%)
Skin
Sjögrens (15%) Skin ... pain (20%) Renal disease ... erythematosus #signs ... #symptoms #diagnosis ... #rheumatology
Stages of Syphilis
Early Primary:
 • Painless chancre
 • Regional lymphadenopathy
Early Secondary:
 • Fever, malaise
 • Rash
Fever, malaise • Rash ... testing • No symptoms ... first year of infection ... lesions in bone, skin ... #signs #diagnosis