Abstract Number: 326

A collaborative care approach to a challenging patient: When dermatology and rheumatology work together

G. Winkler1, K. Gebauer2

Meeting: 2018 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

This poster aims to describe a collaborative care model for the management of a challenging patient. This case highlights the need for a combined dermatology/rheumatology approach to the diagnosis and management of a patient with refractory morphoea like lesions.
Our patient is a 72 year old gentleman who presented with a 3 month history of morphoea like patches on his lower limbs. These progressed rapidly, were associated with significant pain and functional impairment. A peripheral eosinophilia was identified. Superficial and deep cutaneous biopsies were obtained. His cutaneous lesions and systemic presentation did not meet the criteria for any one condition but presently an overlap syndrome between eosinophilic cellulitis and deep morphoea is considered most likely.
His management has included high dose prednisolone and methotrexate at appropriate doses and durations. Both of which failed to halt disease progression. Given concern that the presentation may represent an autoimmune condition or paraneoplastic phenomenon, and for further advice on the use of alternative disease modifying agents, the patient was referred to Rheumatology at a major tertiary hospital for ongoing collaborative management.