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Cure Arthritis Naturally

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CSS cutaneous lesions can be divided into 3 histologic categories: extravascular granulomas (50%), leukocytoclastic vasculitis (33%) and cutaneous 'polyarteritis nodosa' (17%).

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In this study, 14% of 244 WG patients had skin lesions, usually at presentation. Leukocytoclastic vasculitis was the most common cutaneous pathologic pattern. Cutaneous involvement appeared to be premonitory sign of renal disease.

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Thirty-six (40%) of 90 CSS patients had cutaneous signs, as the initial manifestation in 5 of them. The most common clinical presentations were purpura and petechiae on lower extremities, and cutaneous nodules and papules on elbows. The most common histologic findings in skin biopsies (37 specimens) were extravascular necrotizing granuloma (15 specimens) and leukocytoclastic vasculitis (16 specimens).

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de Groot, K., Reinhold-Keller, E., Tatsis, E., et al. 1996. Therapy for the maintenance of remission in sixty-five patients with generalized Wegener's granulomatosis. Methotrexate versus trimethoprim/sulfamethoxazole. Arthritis Rheum. 39, 2052.

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In this study, 35 of 75 WG patients had skin and/or mucosa involvement, mainly palpable purpura (26 patients), oral ulcers (15), skin nodules (6), ulcers (5), necrotic papules (5), gingival hyperplasia (3), pustules (2), palpebral xanthoma

(2), genital ulcer (1), digital necrosis (1) or livedo reticularis (1). At histology, nongranulomatous vasculitis was associated with purpuric lesions, whereas granulomatous inflammation was associated with nonpurpuric lesions. Skin manifestations were associated with a higher frequency of articular and renal involvement (68% vs. 25%; 80% vs. 47%, respectively). These manifestations responded well to steroids and cyclophosphamide, in most of the cases.

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Guillevin, L., Jarrousse, B., Lok, C., et al. 1991. Long term follow-up after treatment of polyarteritis nodosa and Churg-Strauss angiitis with comparison of steroids, plasma exchange and cyclophosphamide to steroids and plasma exchange. A prospective randomized trial of 71 patients. The Cooperative Study Group for Polyarteritis Nodosa. J. Rheumatol. 18, 567.

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Follow-up and multivariate outcome analysis of 260 patients with PAN and 82 with CSS showed that serum creatinine>1.58mg/dl, proteinuria (due to vascular or glomerular disease), GI tract involvement, specific cardio-myopathy and CNS involvement were independent prognostic factors. The five-factors score (FFS) considers these 5 parameters at initial assessment, and is a good predictor of death. Furthermore, FFS can be used to help the clinician choose the most adequate treatment.

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Handbook of Systemic Autoimmune Diseases, Volume 5 The Skin in Systemic Autoimmune Diseases

Piercarlo Sarzi-Puttini, Andrea Doria, Giampiero Girolomoni and Annegret Kuhn, editors

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Arthritis Joint Pain

Arthritis Joint Pain

Arthritis is a general term which is commonly associated with a number of painful conditions affecting the joints and bones. The term arthritis literally translates to joint inflammation.

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