Rheumatoid arthritis (RA) is an autoimmune disease in which the body’s immune system attacks itself and inflames the protective membrane inside the joints. This can result in symptoms that range from mild to severe.
Symptoms are mostly related to joint problems. But you may also experience flare-ups in which your symptoms are worse. This may include rashes on the body due to inflammation.
Other skin conditions associated with RA can include:
- Neutrophilic dermatoses: These can include Sweet’s syndrome, pyoderma gangrenosum, and rheumatoid neutrophilic dermatitis.
- Urticaria: Urticaria, or hives, may occur.
- Rare skin conditions: Sometimes rare skin reactions such as erythema diutinum can occur in people with RA.
- Reactions to medications: Medications such as methotrexate (Otrexup, preservative-free; Xatmep; and Trexall) can trigger rheumatoid vasculitis (RV) and periungual infarcts, or tissue death in the nails due to lack of blood supply.
In most cases, there are treatments available for RA-related rashes.
People with RA can also experience RV. RV is a rare complication experienced in only
RA symptoms can vary according to the severity of the disease. RV occurs when your blood vessels become inflamed. This can lead to other symptoms that range from a red, irritated rash to an ulcer on the skin due to lack of blood flow. RV often occurs on the legs.
Other symptoms that can occur with RV can include:
- appetite loss
- weight loss
- malaise, or lack of energy
Interstitial granulomatous dermatitis is another rash that can occur with RA. Doctors may also call this condition rheumatoid papules. Symptoms associated with the condition include red plaques or bumps that closely resemble eczema.
The rash is itchy and often painful. But interstitial granulomatous dermatitis is very rare in people with RA.
People with RA are prone to episodes known as flares. A flare indicates that there’s increased disease activity in a person’s body.
During a flare, they may have more symptoms associated with the condition, including fever, joint swelling, and fatigue. An RA rash is more likely to occur during a flare.
RV is a complication of RA. It’s caused by the immune system and high levels of rheumatoid factor (RF) in the blood interacting with blood vessels.
This triggers inflammation of small arteries and veins. It can be serious and, while rare, RV
RA can cause complications beyond a rash. Vasculitis can affect blood flow in arteries and veins. The results of severe episodes of vasculitis can be:
- numbness and tingling in the nerves, including loss of sensation in the hands and feet
- affected blood flow to the extremities that can cause gangrene in the fingers or toes
- systemic vasculitis that affects blood flow to the brain or heart that can result in a heart attack or stroke
The occurrence of RV is rare, and the complications above are even rarer. However, it’s possible that a rash could be a indicate that something more severe may occur. See a doctor if you experience any symptoms of RV.
The treatment for an RA-related rash depends on its cause and severity. A treatment that works well for one type of rash may be useless for another.
Treatment usually focuses on managing pain and discomfort and preventing an infection. It’s also important that treatments target the underlying condition, since rashes may be a sign that your RA isn’t well controlled.
Common over-the-counter (OTC) medications that may reduce the pain of a rash include acetaminophen (Tylenol). Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs) for RA rashes, as these can be organ threatening.
Drugs to avoid can include:
- ibuprofen (Advil, Motrin IB, Nuprin)
- naproxen sodium (Aleve)
- aspirin (Bayer, Bufferin, St. Joseph)
If your pain is severe, a doctor may also consider prescription pain relievers. Opioid pain drugs are usually only prescribed for very severe pain since they have a high risk of addiction.
A doctor may also prescribe corticosteroids to reduce the inflammation of your rash, which may in turn reduce painful symptoms.
But these drugs aren’t recommended for long-term use. If the doctor is concerned that your rash could get infected, they’re likely to prescribe either a topical or oral antibiotic or both.
When it comes to treating the underlying condition, there are several different medication options available:
These drugs treat RA by reducing the immune responses that damage your joints. But since they compromise your immune system, they also raise your risk of illnesses and infections.
Disease-modifying antirheumatic drugs (DMARDs) and biologics are two types of immunosuppressant drugs. DMARDs decrease inflammation and can slow the progression of RA. Biologics are injectable drugs that target specific immune cells to reduce inflammation.
DMARDs and biologics aren’t recommended for anyone with a compromised immune system.
Janus-associated kinase (JAK) inhibitors are the next line of treatment when other immunosuppressant drugs aren’t working. They help prevent inflammation by affecting genes and immune cell activity.
There are specific treatments for different types of RA rashes.
For RV, treatment usually starts with corticosteroids, such as prednisone. DMARDs, such as methotrexate, may also be prescribed to treat the underlying condition.
Treatments for interstitial granulomatous dermatitis include topical steroids and antibiotics.
Sometimes a rash occurs due to a change in medications. You should tell a doctor if you have symptoms after changing medications. But you shouldn’t stop taking your medications unless instructed by a doctor.
There are no permanent solutions that can completely prevent RA rashes from occurring. Doctors may try a combination of medications to help you manage your condition. These treatments may reduce inflammation and minimize joint damage.
It’s important that people with RA take measures to live as healthy a lifestyle as possible. Examples of lifestyle practices that may benefit a person with RA include:
- Getting plenty of rest, which can help to reduce fatigue symptoms and minimize joint inflammation.
- Exercising whenever possible, which can help to enhance joint mobility and build strong, flexible muscles.
- Taking measures to cope with stress, such as meditation, reading, taking a walk, or doing other activities to promote relaxation.
- Eating a balanced diet full of fruits, vegetables, whole grains, and lean proteins. This can help you maintain a moderate weight, which is important in supporting joint health.