🚨 DID YOU KNOW that if hair grows on your ears, it’s because your body is… see more
The skin, the eyes, and the ears are sense organs which are very frequently involved in rheumatic diseases. The skin is an easily accessible organ to physical examination and biopsy. Taking into account the morphology, location, distribution, and histological characteristics of cutaneous manifestations in patients with rheumatic disorders, particular skin rashes may aid the diagnosis (e.g., butterfly rash, systemic lupus erythematosus) and/or define disease activity and prognosis (e.g., raised purpura, risk factor for lymphoma development in patients with Sjögren’s syndrome).
Ocular manifestations may serve as a guide to proper diagnosis of an au
toimmune disorder or indicate necessity for intensified treatment of the underlying rheumatic disease. Keratoconjunctivitis sicca, keratitis, uveitis, scleritis, and retinal vasculitis are often diagnosed in patients with rheumatic diseases. Some ocular symptoms of rheumatic diseases (e.g., amaurosis fugax in giant cell arteritis) or of drugs used to treat the diseases (e.g., antimalarial agents causing maculopathy) are sight-threatening, and they should be recognized promptly to prevent permanent loss of vision.
Ear manifestations of rheumatic diseases can often be the initial symptom of an undiagnosed autoimmune disease. Hearing disturbances may be encountered in systemic lupus erythematosus, relapsing polychondritis, Sjögren’s syndrome, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, Cogan syndrome, sarcoidosis, and Behçet’s disease. They can manifest as otalgia, otitis, uni- or bilateral sensorineural or conductive hearing loss, as well as audiovestibular deficits.
The questions and answers of this chapter aim (a) to familiarize a rheumatologist and any related subspecialty physician with the vast variety of rashes associated with rheumatic diseases, (b) to depict the different ocular manifestations of autoimmune diseases, and (c) to raise the clinical awareness that hearing disturbances can be the initial manifestation of a rheumatic disease.
