Five Cases of Palindromic Rheumatism.

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  • HIGAKI Yuko
    Department of Dermatology, Tokyo Women’s Medical College
  • YAMASHITA Hiroko
    Department of Dermatology, Tokyo Women’s Medical College
  • HIDANO Akira
    Department of Dermatology, Tokyo Women’s Medical College
  • SATO Kazuto
    Institute of Rheumatology, Tokyo Women’s Medical College

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  • 回帰性リウマチの５例

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Five patients were suffering from recurrent attacks of joint pain and swelling either with or without tender indurated erythema for from 2 to 20 years. The laboratory findings were normal except for the raised erythrocyte sedimentation rate, and transient positive CRP during the attacks. None of the patients showed radiological abnormalities as normally seen in rheumatoid arthritis. All patients showed one particular characteristic attack, called para-articular attack; the presence of a tender, indurated erythema on the palm and sole which appeared suddenly and then resolved spontaneously within a week. A histological examination of these indurated erythema revealed perivascular lymphocytes and neutrophil infiltration in the dermis. On the other hand, exudative erythema with a peri-articular attack around the internal malleolus histologically showed an exudation of fibrinoid material beneath the epidermis as well as perivascular and scattered cell infiltration mainly consisting neutrophils in the entire dermis. Anti-inflammatory drugs were effective in reducing the pain although the duration and the intervals of attacks remained unchanged in 4 cases.

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