Rheumatoid nodules are a skin manifestation of rheumatoid arthritis (RA). This autoimmune disease is most often associated with painful, swollen joints but symptoms of rheumatoid arthritis can also be detected in multiple organs, including the skin.
Although the condition causes a variety of skin symptoms, rheumatoid nodules are the most common. Also known as rheumatoid granulomas, the nodules are typically associated with severe RA and appear close to affected joints. The flesh-colored, moveable lumps range from pea sized to walnut sized and, occasionally, even larger.
Some rheumatoid nodules are soft and squishy, while others are firm, and most are painless. When pain does occur, it is usually due to nerve pressure, limitation of movement or underlying inflammation or infection.
Most dermatologists diagnose rheumatoid nodules through physical examination along with a patient history of rheumatoid arthritis. Blood work can confirm a high rheumatoid factor.
Certain RA medications can shrink the nodules, while others can cause the nodules to grow. If rheumatoid nodules are not painful, no treatment is necessary. However, dermatologists may treatment nodules that are infected, ulcerated, painful or interfering with movement.
Treatment options to reduce rheumatoid nodules include corticosteroid injections or surgical excision. Unfortunately, RA nodules that are removed surgically often redevelop. Most dermatologists recommend against treating painless rheumatoid nodules when treatment is based solely on cosmetic concerns.