Rheumatoid Arthritis (RA) Rash
Although rheumatoid arthritis primarily results in joint pain, swelling, and inflammation, it is also capable of causing a rash.

Skin issues in rheumatoid arthritis (RA) may arise due to the disease itself or as a side effect of medications used to treat RA. RA rash treatment usually focuses on the underlying medical condition rather than the rash itself. This theory is the rash will disappear if the severity of the RA symptoms is reduced through proper medications.

Treatment is determined on the cause and severity of the symptoms and may include a mix of topical and systemic medications.

  • If an RA rash is particularly severe or has the potential to cause an ulcer, a doctor would most likely treat the rash immediately. Typically, this technique includes the use of topical antibiotics or steroids. Topical steroids are frequently successful in minimizing the inflammation associated with the rash.
  • Antibiotics may also be prescribed to treat any existing infection.
  • Some over-the-counter skin lotions and ointments can occasionally be applied to RA rashes without a doctor's prescription. These may help reduce pain and/or itching related to the rash even as you treat underlying RA symptoms. 

While these treatments are usually beneficial in treating an RA rash, sometimes, RA medication that a person is currently taking causes a skin rash. In these circumstances, it is recommended to consult a doctor to modify their existing medicine so that the rashes do not persist or worsen.

What are the signs and symptoms of an RA rash?

Rheumatoid arthritis (RA) rashes are induced by inflammation of the arteries that carry blood to various organs, including the skin and nerves. People with RA may develop red spots or patches due to inflammation. Signs and symptoms of an RA rash vary depending on the type. Symptoms usually manifest on both sides of the body.

Palmar erythema or red palms

Affects about 60 percent of people with RA. Palmar erythema develops when small arteries in the hand dilate, drawing more blood to the surface.

Symptoms may include:

  • Redness in both hands, maybe extending to the fingers
  • Redness accompanied by a sensation of warmth
  • It does not usually itch or hurt

The degree of redness can also alter in response to changes in temperature, raising your hand, or feeling anxious.

There is no particular therapy for palmar erythema. However, systemic RA medications may be helpful.

Rheumatoid vasculitis (RV)

People with severe RA for at least 10 years are more likely to develop this condition. Inflammation causes small and medium-sized blood vessels to constrict in RV. This causes a disruption in blood flow to the skin. Smoking increases the likelihood of getting an RV.

Among the signs and symptoms are:

  • Spots, pits, or sores around the fingernails
  • Redness, swelling, and pain in the fingers or fingertips
  • A painful red rash, typically on the legs, if larger blood vessels become inflamed
  • Skin ulcers

Other signs and symptoms include:

Topical antibiotics, corticosteroids, immunosuppressants, or biologic medicines may be used to treat RV.

Rheumatoid neutrophilic dermatitis

A rare skin condition associated with long-standing RA. It usually presents as:

  • Red, blue, or purple rashes on both arms and/or legs and may emerge on a  limb or the torso.
  • Blisters or skin ulcers in severe cases.

Interstitial granulomatous dermatitis

Another uncommon skin condition linked to autoimmune illnesses such as RA.

Symptoms might include:

  • Skin-colored bumps or patches, most commonly on the chest, stomach, back, and limbs.
  • Patches may vary in size or shape over several days or months. This condition is typically not painful.
  • Mild itching or burning may develop in some people.

Topical or oral corticosteroids, dapsone (an antibiotic with anti-inflammatory characteristics), and hydroxychloroquine may be used to treat rheumatoid neutrophilic dermatitis and interstitial granulomatous disease.

If your rash is bothering you, see your doctor about the best over-the-counter pain relievers for you. In rare circumstances, stronger pain medicines may be administered.

QUESTION

The term arthritis refers to stiffness in the joints. See Answer

How can I protect myself from an RA rash?

Although rheumatoid arthritis (RA) is primarily known for joint pain, swelling, and inflammation, it is also capable of causing a rash.

It may not always be possible to prevent the rash, but some tips may lower its risk: 

Protect skin from the sun

  • If you have RA, you should apply sunscreen and limit your exposure, as your risk of some forms of skin cancer may be heightened, mainly if you use certain drugs. Your arthritis drugs may also make your skin more susceptible to sunlight. 
  • Follow up with your dermatologist regularly for a complete skin examination to avoid complications.

Avoid smoking

  • According to research, smokers are more likely to develop an RA rash. As a side effect of RA therapy with tumor necrosis factor inhibitors, smokers are also more prone to get psoriasis.

Be prompt with vaccinations

  • People with RA are almost twice as likely to develop infections such as flu and pneumonia. Consult your rheumatologist to determine whether, when, and what sort of vaccine is appropriate for you.

There are no long-term solutions to prevent RA flare-ups and rashes. Your doctor can, however, prescribe a combination of therapies to control these symptoms, and these treatments can help manage discomfort, reduce inflammation and minimize joint damage.

It is also imperative that you make the required efforts to maintain a healthy lifestyle by:

  • Getting plenty of rest.
  • Staying active.
  • Coping with stress.
  • Eating a healthy diet.
  • Following your treatment plan.

What are the possible complications of an RA rash?

Rheumatoid arthritis (RA) rashes are one of the most serious consequences of RA. The rash commonly appears on the fingers although it can appear anywhere on the body and can be uncomfortable. They appear red on the skin and are frequently irritating. They can also seem like pinpricks at times.

Although it is unusual and only occurs in severe circumstances, these rashes can cause painful ulcers. Once the ulcers are present, they can occasionally get infected, causing further problems and difficulty during therapy.

Common complications of an RA rash include:

Necrosis

  • RA can induce necrosis (tissue death or gangrene) in the fingers and toes, which can lead to amputation in severe instances.

Numbness and tingling

  • This is a complication of rheumatoid vasculitis, which involves inflammation and constriction of blood vessels and nerve damage.

Sepsis

  • Severe RA can put you at risk of sepsis, an infection that can cause tissue damage, organ failure, and even death if not treated promptly.

Ulceration

  • Ulcers can develop as a result of RA skin rashes, which might be difficult to treat as healing is not always successful.

If you get an RA rash, contact your rheumatologist right away, as it might be a response to one of your RA drugs. Your doctor can perform several tests to examine your skin health and, if necessary, change your RA prescription. 

Adding a skin rash while dealing with other RA symptoms is difficult, but there is hope. If you have RA skin rashes or other symptoms, contact your rheumatologist who can help you discover the reason and develop an appropriate treatment plan. Your doctor can refer you to other specialists so you can feel better and live your best life hopefully without a rash.

SLIDESHOW

What Is Rheumatoid Arthritis (RA)? Symptoms, Treatment, Diagnosis See Slideshow

Health Solutions From Our Sponsors

Medically Reviewed on 10/20/2022
References
Image Source: iStock image

When Rheumatoid Arthritis Causes Skin Problems: https://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-skin-problems

Rheumatoid arthritis and the skin: https://dermnetnz.org/topics/rheumatoid-arthritis-and-the-skin

Can Rheumatoid Arthritis Cause a Rash? https://www.emedicinehealth.com/can_rheumatoid_arthritis_cause_a_rash/article_em.htm