Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Other dermatoses

Rheumatoid / rheumatic nodules

Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns (Canada) (see Reviewers page)
Revised: 2 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.


● Associated with adult and juvenile rheumatoid arthritis and rheumatic fever, in extensor elbow and other joints
● Usually subcutis
● Large, firm, asymptomatic, dome-shaped masses; may be painful
● Subcutaneous lesions develop at sites of trauma or at pressure points
● May involve abdominal wall and heart

Clinical images

Rheumatoid nodules of fingers

Micro description

● Typically in subcutaneous fat or soft tissue, although may extend to deep reticular dermis
● Note that granuloma annulare and necrobiosis lipodica have more superficial locations
● Fibrin deposition and necrobiosis is often seen in center of nodule surrounded by well developed palisading of histiocytes, vascular granulation tissue, lymphocytes, plasma cells, eosinophils, variable giant cells, fibrosis in older lesions, occasional giant cells
● No asteroid inclusions
● Occasionally leukocytoclastic vasculitis

Micro images

Rheumatoid nodule-subcutis

Virtual slides

Rheumatoid nodule

Differential diagnosis

● Deep granuloma annulare, which tends to have more mucin deposition and less fibrin
● Epitheloid sarcoma

End of Skin-nontumor > Other dermatoses > Rheumatoid / rheumatic nodules

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at [email protected] with any questions (click here for other contact information).