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July 1969

The Histopathology of Rheumatoid Episcleral NodulesAn Extra-articular Manifestation of Rheumatoid Arthritis

Arch Ophthalmol. 1969;82(1):77-78. doi:10.1001/archopht.1969.00990020079017

ACCORDING to Duke-Elder and Leigh-Duke-Elder four types of episcleral or scleral inflammation can be firmly ascribed to the collagen diseases, and particularly to rheumatoid arthritis.1 These are rheumatoid episcleral nodules, necrotizing nodular scleritis, scleromalacia perforans, and massive granuloma of the sclera. Nodular episcleritis is relatively uncommon in the collagen diseases, occurring most frequently in rheumatoid arthritis.1 Only three cases of rheumatoid episcleral nodules studied histopathologically have been reported.2-4 These lesions are localized areas of granulomatous inflammation in which the histopathologic picture closely resembles that seen in subcutaneous rheumatoid nodules.

The purpose of the present paper is to report the fourth case in which an rheumatoid episcleral nodule has been examined pathologically, and to emphasize the specific histopathologic pattern exhibited by these lesions.

Report of a Case  A 63-year-old white woman was admitted to the hospital complaining of pain in the joints, particularly in her shoulders. She had

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