Signs and Symptoms of Connective Tissue Disease

Interview Topics
0:08 How are connective tissue diseases like rheumatoid arthritis and lupus presenting first in the skin?
1:44 What are the non-dermatologic symptoms that should send a signal to clinicians that this is likely a connective tissue disease?
2:52 What are some of the rare rheumatic conditions that fall under the connective tissue disease umbrella?

Summary:

The interplay between dermatology and rheumatology is increasingly involved in modern medicine, as advances to inflammation-targeting pharmacotherapy and shifts in standard specialty care team makeup has warranted a greater collaboration between specialists in either field for their overlapping patients’ sakes.

What becomes more crucial because of this shift, though, is timely diagnostics—catching systemic presentations of connective tissue diseases, regardless of the symptom and the background of the specialist identifying it.

In the second segment of an interview with HCPLive during the Society for Dermatology Physician Assistants (SDPA) 2024 Summer Meeting, Amanda Mixon, PA-C, physician assistant at UCHealth Rheumatology Clinic, discussed how to first identify rheumatic conditions like rheumatoid arthritis (RA) and systemic lupus erythematosus in the skin—and vice versa. Interestingly, each of these connective tissue diseases present in the skin in multiple ways. In fact, lupus is associated with so many skin manifestations that it’s often going undiagnosed first in dermatology visits.

“With rheumatoid arthritis, patients from a skin perspective can have rheumatoid nodules that often will present to dermatology. You can have a cutaneous vasculitis that's associated with rheumatoid arthritis,” Mixon explained. “With systemic lupus, there are lots and lots of different skin manifestations. And most commonly, we talk about this thing called the butterfly rash; it's kind of this skin rash on the face.”