Extra-articular manifestations of RA

1. What sort of patients are most likely to have extra-articular manifestations of RA?
*2. What are skin manifestations of RA?
3. What are ocular manifestations of RA?
4. What are pulmonary manifestations of RA?
5. What is Caplan's syndrome?

Answers:
1. RF+, with rheum nodules, severe articular disease, and MHC class HLA DRB1 alleles.
2. SubQ nodules (also seen in gout) are present in 50% of RA patients, forming subQ in bursae and along tendon sheaths, and may be enhanced by methotrexate. There may also be vasculitis lesions such as leukocytoclastic vasculitis and palpable purpura.
3. Keratoconjunctivitis sicca (dry eyes), episcleritis (benign), scleritis (severe inflammation).
4. Interstitial lung disease (fibrosis), pulm fibrosis, pleurisy, bronchiolitis obliterans.
5. Caplan's syndrome is interpulmonary nodules, similar to rheum nodules, associated with RF+ rheum arthritis and pneumoconiosis in coal works.