Extra-articular involvement of the skin in patients with rheumatoid arthritis is not uncommon. A patient with this condition is reported who developed an unusual cutaneous eruption associated with systemic upset. Skin biopsy showed a dense dermal neutrophilic infiltrate and after treatment with standard immunosuppressive agents had failed he responded to dapsone. The rash recurred on withdrawal of the dapsone but has responded to sulphamethoxypyridamine. It is proposed that this condition is a rare but specific entity of unknown cause associated with rheumatoid arthritis.
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