Rheumatoid Arthritis (RA) Rash

Rheumatoid arthritis (RA) is an inflammatory disease that attacks healthy tissue in the joints, leading to swelling and reduced mobility. Skin rashes are often associated with psoriatic arthritis, but one study found that 27.5% of people experienced RA skin rashes.

Rheumatoid arthritis rashes range from purplish bruises with rheumatoid vasculitis (RV) to itchy patches of skin with neutrophilic dermatitis. Here's everything you need to know about RA-related rashes, treatment, and more.

What Does a Rheumatoid Rash Look Like?

RA rashes vary in presentation. A person with an RA rash may have:

  • Nodules or plaques
  • Painful, red rash (usually on the legs)
  • Papules—cyst-like lesions on the skin
  • Purple bruises

This photo contains medical imagery.

Rheumatoid arthritis rash

DermNet

Rheumatoid arthritis rash

DermNet

Rheumatoid Vasculitis (RV)

Around 2 to 5% of people diagnosed with RA will develop rheumatoid vasculitis (RV). The hallmark of this condition is inflamed blood vessels. Most often, the affected blood vessels are arteries that bring blood to the skin and nerves.

RV presents as a painful red rash or purplish bruises. It can sometimes affect your internal organs as well. If you have symptoms of RV, you need to see a healthcare provider right away.

Other Symptoms of RV

Beyond a rash, people with rheumatoid vasculitis can also have other symptoms, including:

  • Abdominal pain
  • Chest pain
  • Fatigue
  • Fever
  • Loss of appetite
  • Muscle weakness
  • Numbness
  • Redness or sores around the nails
  • Small pits on the fingertips
  • Tingling
  • Tissue death—necrosis—of the fingers or toes
  • Weight loss


Palmar Erythema

More than 60% of people have palmar erythema (PE) along with rheumatoid arthritis. This type of rash looks like red splotches on your palms. Some people may experience some pain with palmar erythema.

Rheumatoid Neutrophilic Dermatitis

This rare skin manifestation—affecting less than 2% of people with RA—can produce red bumps, nodules, plaques, or itchy skin patches. It occurs more commonly in people with severe arthritis.

Interstitial Granulomatous Dermatitis

Another rare rash associated with RA is interstitial granulomatous dermatitis (IGD). Reddish plaques and discolored nodules or papules are signs of IGD. This rash appears on the truck and lower body areas and occasionally presents as a long cord-like welt, known as the rope sign.

What Causes RA Rashes?

RA rashes seem to have an inflammation component, which is an immune system response. For example, Juan J. Maya, MD, a rheumatologist at the Rheumatology Center of Palm Beach in Florida, told Health that RV is an immune reaction related to the heightened autoimmune state linked to RA.

Possible Complications

Among the different skin issues that can occur with RA, there are potential complications, such as:

  • Heart attacks and strokes with RV
  • Lesion reoccurrence with neutrophilic dermatitis
  • Ruptures, skin infections, and ulcers with RA nodules

Treatment

Treatment options for RA rashes vary according to how severe the condition is. The primary treatments for RA include antirheumatic drugs, biologics, and corticosteroids.

Anti-Rheumatic Drugs

Treating RA as a whole can be beneficial for treating the skin rashes that appear. Disease-modifying antirheumatic drugs (DMARDs) are a first-line treatment for RA. Their role is to help with immune regulation and inflammation.

Biologics

These human-made, protein-based medications help calm the immune system. They can be an effective treatment option for RV.

Corticosteroids

In some cases, corticosteroids—or steroids for short—can be beneficial for RA rashes because they can promote reduced inflammation. Steroids may be a treatment for many of the rashes linked to RA, such as neutrophilic dermatitis, RV, and IGD.

A Quick Review

Although uncommon, rheumatoid arthritis can cause different rashes—including rheumatoid vasculitis (RV), palmar erythema (PE), neutrophilic dermatitis, and interstitial granulomatous dermatitis (IGD). It's suggested that these rashes can be the result of inflammation.

It's best to seek care from a healthcare provider if you have rheumatoid arthritis and notice a rash on your body. RA rashes can come with complications but are treatable with options like steroids and biologics.

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11 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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