Rubber-like bumps under the skin can be a result of rheumatism – especially if they appear on the elbows, fingers or feet. We explain what rheumatoid nodules are and which treatment helps.
There are hundreds of types of rheumatismthat express themselves very differently and also have different causes. The most common – and probably best known – is rheumatoid Arthritis, where the Joints ignite again and again. These Inflammation cause pains and Swelling, in addition, the joints become stiff, making them difficult to move. In some of those affected, however, another symptom occurs: so-called rheumatoid nodules.
What are rheumatoid nodules?
Rheumatic nodules are about two to three centimeters in size in the fatty tissue under the High. They usually don’t hurt. In some people affected, however, they can be reddened and tender to pressure.
The nodes owe their name to the fact that they are often associated with rheumatoid arthritis. However, they also occur in other diseases, such as rheumatic fever or Infectious diseases how Lyme disease or Syphilis.
Formation and histology of rheumatoid nodules
Rheumatic nodules are a side effect of diseases that are associated with inflammation. Inflammation is a defense reaction of the body. In the case of infections, they are directed against pathogens. Certain diseases such as rheumatoid arthritis are caused by disorders in the body’s immune system.
The inside of the nodes consists mainly of material that arises from inflammation: dead tissue and certain cells of the immune system, so-called scavenger cells (macrophages). These defense cells are so named because they take over the task of garbage chutes in the event of inflammation: They build waste – such as bacteria and dead tissue – and ensure that it is removed.
Sometimes the phagocytes cannot completely break down the waste that accumulates in the tissue when there is inflammation. Then they separate it from the surrounding tissue so that it at least does not affect it: This creates a rheumatoid nodule.
In the rheumatoid nodule, the cells change their shape: some of them join together to form so-called giant cells, which then contain several cell nuclei due to the fusion. Others develop properties of so-called epithelial cells. Epithelium is the outermost layer of cells that line the inner and outer surfaces of the body.
Rheumatoid nodules on the elbow, foot or finger
In rheumatoid arthritis, rheumatoid nodules mainly appear near the inflamed joints, for example in the area
- the wrists and fingers,
- the ankle and toe joints as well
- on the elbow and forearm.
Usually the nodes reach a diameter of two to three centimeters, but they can also get larger. They usually don’t cause pain, but in some cases the skin that covers them is a bit tender.
Rheumatoid nodules are by no means found in all people with rheumatoid arthritis, but only in around 20 to 30 out of 100 sufferers. Above all, people are affected who have been afflicted by joint inflammation over and over again for years. On average, rheumatoid nodules do not develop until about 11 years after rheumatoid arthritis is diagnosed.
The exact cause of the lump is not clear. What is certain is that they are not a direct consequence of arthritis, i.e. joint inflammation.
Rheumatoid nodules on other parts of the body
Rheumatoid nodules can also appear on parts of the body other than the hands and feet, for example on the ears or in the Mucous membrane of the larynx in the area of the vocal cords and internal organs, for example the Lunge.
If the larynx is affected, sufferers often feel it Throat irritation and get hoarse for no apparent reason – say one cold or cigarette smoke. Since these complaints can be extremely stressful and damage the voice, it is – unlike rheumatoid nodules on arms, hands or feet – usually necessary to treat the nodules in a targeted manner. (You can find out more about the therapy in the chapter “How can rheumatoid nodules be treated?”)
Rheumatoid nodules in the lungs occur particularly in smokers with longstanding rheumatoid arthritis, with men being affected slightly more often than women. As a rule, they do not cause any discomfort and in many cases are not dangerous. Sometimes they are only noticed by chance on x-rays or computed tomography (CT) images of the lungs.
Then it is important that the doctor clarifies whether it is really a rheumatic nodule or a malignant growth, i.e. Krebs. In the case of larger lumps, a small tissue sample may need to be taken.
How can rheumatoid nodules be treated?
Rheumatoid nodules are not dangerous and therefore do not necessarily need to be treated. If they get big and are bothersome, there are two treatment options: Your doctor can
- inject an anti-inflammatory agent (cortisone preparation) into the lump or
- surgically remove the rheumatoid nodule.
What is more important, however, is the treatment of the underlying disease, in most cases rheumatoid arthritis. Those affected mostly get Medication prescribed to relieve the inflammation of the joints and ensure that there are fewer flare-ups.
However, the drugs do not necessarily help against the rheumatoid nodules. In some sufferers, the lumps actually enlarge when they start treatment. There is evidence that certain anti-rheumatic drugs may promote rheumatoid nodules, including the best-known and most widely used rheumatic drug methotrexate. However, this connection has not yet been clarified with certainty.
Important: Worrying about rheumatoid nodules should not stand in the way of rheumatoid therapy. In contrast to the relatively harmless lumps under the skin, rheumatic joint inflammation can have devastating consequences if it is not treated in time.
Can rheumatoid nodules go away?
Yes, rheumatoid nodules can shrink and regress on their own. However, this happens spontaneously, if at all. It is therefore impossible to say in advance whether a rheumatoid nodule will continue to grow or disappear again.
Treating rheumatoid nodules naturally – is that possible?
Many sufferers wonder whether they can treat their rheumatoid nodules naturally – for example with the help of herbal remedies or through the nourishment. However, there is currently no herbal preparation available with which the nodes can be verifiably reduced or even removed.
It has not been researched whether diet has an effect on the nodes. Basically, there is evidence that diet can influence certain inflammatory processes in the body. However, it is completely unclear and controversial among experts whether certain forms of nutrition could counteract rheumatic inflammation.