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Beauty can be only skin deep

I was told years and years ago that RA would be evident through my skin.  At the time (in my early forties) I really had no idea just how important that information would become down the road a piece.

One item to be considered is Rheumatoid nodules.  I did not actually get any of these for a number of years and even now I have very few and they come and go.  But for some they can be troublesome and annoying.  The fact is these hard lumps of tissue range in size from about the size of a pea to as large as a ping pong ball. They may develop under the skin over bony areas such as the elbow, ankle, or finger. They can also form on organs such as the lungs. For many, if not most people, treatment with “DMARDs” (disease-modifying antirheumatic drugs) or steroid shots may shrink nodules. You may need surgery to remove them if they get infected or become too painful.

Although rare, in some folks nodules may be an indicator that they are experiencing rheumatoid vasculitis, which is inflammation of the small and medium-sized blood vessels.  When the small vessels of the fingertips and around the nails are affected, the result can be small pits on the fingertips or small sores or redness around the nail. If it happens in larger blood vessels, it can cause a painful rash, often on the legs. In serious cases, ulcers can form and there’s a chance they could become infected.  That is why it is always good to let your physician know of any changes to your skin.

Skin rashes can result from any number of things ranging from medication side effects like allergies or sensitivity of some sort.  If you start with a skin rash at any point consult your physician promptly and if it is accompanied by any other symptoms like swelling, redness or fever call them immediately.  No point in taking chances.

Sun sensitivity is common for many of us with RA.  It is a side effect of some of the treatments and medications we take but I have also noticed that even when I was off of the medications known for inducing that I still seemed to have a more intense response to the sun.

Bruising is one of the most annoying and difficult ones to deal with.  I bruise so easily now that it takes little more than a brush against my skin for one to appear.  When I really wallop a spot with force the resulting bruise can last for weeks if not months.  I have always been a tad clumsy but now the price I pay is not only painful but unsightly. I have found that using a bruise reducing ointment like arnica gel can help with the healing process.  I have also been known to put some tinted cream on them when going out socially.  For me they seem to be from the use of the corticosteroids but I know of folks who do not take them and still bruise quite easily.

Regardless of the how and why – taking extra care of our skin and keeping a close eye on any changes will make the management of this aspect of RA a lot smoother.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • robinjane
    1 year ago

    I’ve had a nodule on the bottom of one foot for years. Had surgery that removed part of it but it still feels like half a hard boiled egg! Orthotics help some.

  • Tich
    2 years ago

    I had nodules on the back side of one knee about fifteen years before I was diagnosed with Ankylosing Spondylitis. I started treatment due to scleritis, so we began right off with biologics and we tried them all. Eventually I developed eczema and high liver enzymes. Reaction to treatment can be very bad for skin.

  • rhonda
    4 years ago

    Thanks for this information. I have a few nodules on my finger joints but have also noticed recently pits in my finger nails. I guess I didn’t realize this was connected to my ra. I will be sure to discuss this with my Dr.

  • Pat
    4 years ago

    I have found that using arnica gel or cream on those bruises makes them disappear in days as opposed to weeks. I was shocked, but it works very well!!

  • Nan Hart moderator author
    4 years ago

    I would check with your physician to see what thoughts he/she might have. I have found that once my RA was under control treatment wise the nodules decreased in size and occurrence. That is not true for everyone but over time it if happen for me.

  • chrisj
    4 years ago

    I have a nodule on the big toe joint near the side of my foot. Spent all day trying to find shoes to fit but no luck. I had it removed about 7 years ago and it grew right back. Does anyone know if it is possible to stop them from growing back somehow?

  • jas
    4 years ago

    I have been getting swelling and nodule like on my scalp! anyone else? its is on the front of the temporal bone joints
    I have the all over my hands and toes for years but this threw me back.
    id lov eto hear if anyone else has had scalp issues?

  • SweetT
    4 years ago

    Please look into EDS (Ehlers Danlos), some of the things you wrote about are triggering a concern.

  • Janice
    4 years ago

    Prurigo Nodularis and Sarcoidosis, yes, both. It is not just about aching bone joints.

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