Over the last few years, technological advances have resulted in dramatic improvements in quality and resolution of ultrasonography (US), allowing it to become a very powerful tool in rheumatological clinical practice. Despite the fact that the impact of US on final diagnosis or therapeutic options for rheumatic patients has not yet been defined, there is now growing evidence that US improves clinical diagnosis and intervention skills. This review discusses the most important issues connected with the practice of US in rheumatology including: basic requirements, scanning technique, clinical applications, training and future developments. Moreover, it provides a general overview of both US anatomy and pathology relevant for the rheumatologist.

/pdf/ultrasound-imaging-for-the-rheumatologist-4ii8nc1izh.pdf

Ultrasound imaging for the rheumatologist.

Giornale italiano di Dermatologia e Venereologia

Mechanisms of autoantibody production and the relationship between autoantibodies and the clinical manifestations in Sjögren's syndrome.

https://www.cidjournal.com/article/S0738-081X(06)00097-6/pdf

Sjögren's syndrome in dermatology.

The association of kerato-conjunctivitis sicca and xerostomia has been termed Sjogren's syndrome (SS). Although this disease is referred to as a non-organ-specific autoimmune condition, the vast majority of the deleterious effects of primary SS are restricted to the exocrine glands. Among them, the lacrymal and salivary glands are at the foreground, owing to the severity of the objective consequences and the importance of the subjective manifestations. As a result, cutaneous manifestations are minimized, albeit relatively common. We have carefully analyzed the literature to draw up an inventory of the possible skin complications of this syndrome. In addition to xerosis and epidermal IgG deposits, they include vasculitis and cutaneous B cell lymphoma. Alopecia, vitiligo and papular lesions have also been reported to be associated with primary SS.

Cutaneous manifestations of primary Sjögren's syndrome are underestimated.

Objective Various cutaneous manifestations have been described (xerosis, eyelid dermatitis, angular cheilitis, cutaneous vasculitis and annular erythema) in Sjogren's syndrome (SS), but so far only three studies on large numbers of SS patients have been carried out The frequency of cutaneous manifestations and their association with specific clinical or immunological parameters have never been studied The aim of the Italian Group of Immunodermatology was to evaluate these associations in a large number of SS patients Methods A retrospective review was performed on 93 patients with SS followed over a ten-year period (1990-2000) at 6 Italian dermatological centers They were subdivided into two groups, 62 with primary SS and 31 with secondary SS, and the frequency of cutaneous manifestations and specific antibodies was determined and compared between them Results We found significantly higher levels of xerosis (p = 0009) (564% versus 258%) and angular cheilitis (p = 0017) (387% versus 161%) in primary SS patients than in those with secondary SS A significant association of xerosis with anti-SSA + SSB (p = 0033) antibodies was also demonstrated Eyelid dermatitis and pruritus were common but less specific cutaneous symptoms Annular erythema was found more often in primary (645%) than in secondary (32%) SS and was associated with SSA + SSB antibodies in 75% of the cases Cutaneous vasculitis was present in 306% of primary SS (manifesting as palpable purpura in 84%) and in 293% of secondary SS cases Conclusion Xerosis is the most frequent and characteristic cutaneous manifestation of primary SS It is not linked to decreased sebaceous or sweat gland secretion, but more probably to a specific alteration of the protective function of the stratum corneum Angular cheilitis is a common but less specific skin lesion in SS and is associated with xerosis and xerostomia

Sjögren's syndrome: a retrospective review of the cutaneous features of 93 patients by the Italian Group of Immunodermatology.

We retrospectively studied 132 patients with dermatomyositis; 84 had idiopathic, 30 paraneoplastic, 5 juvenile and 13 amyopathic forms of the disease. The commonest features were macular erythema, heliotropic erythema and Gottron's papules. Flagellate erythema occurred in 5% of patients with idiopathic dermatomyositis and correlated with the disease activity. Necrotic lesions were also found in this group of patients but did not always signal malignancy. The prevalence of malignancy was high (23%). Raynaud's phenomenon occurred in 10.6% of patients, also in those with malignancy. Dysphagia, interstitial lung disease and arthralgias affected 20%, 8% and 40% of patients, respectively. Anti-Jo-1 antibodies were found in 5% of patients with idiopathic dermatomyositis and low titre ANA in 1/3 of patients. ANA did not correlate with the disease activity. We confirmed the data from the literature, but no cutaneous sign, constitutional symptom or circulating antibody was found marking a particular subtype of the disease.

Dermatomyositis in 132 Patients with Different Clinical Subtypes: Cutaneous Signs, Constitutional Symptoms and Circulating Antibodies

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Sjögren's syndrome: a retrospective review of the cutaneous features of 93 patients by the Italian Group of Immunodermatology.

Dermatomyositis in 132 Patients with Different Clinical Subtypes: Cutaneous Signs, Constitutional Symptoms and Circulating Antibodies