To analyse the frequency, type, and immunohistological features of clinical cutaneous vasculitis developing in patients with rheumatoid arthritis (RA) treated or not with methotrexate as well as their demographic, clinical and biological characteristics.
Ninety-one patients with RA receiving 9.5 mg/wk of methotrexate (MTX) were compared for an average observation time of 18 months to 130 matched patients with RA treated with various drugs excluding MTX.
Whether receiving MTX or not, 5.4% of patients with RA developed a clinical cutaneous vasculitis. There were significant differences between both groups for 2 variables only: a higher percentage of polyneuropathies and a higher level of immune complex-plasma levels in non-MTX patients. The immunohistological analysis did not differentiate both groups.
The percentage of cutaneous vasculitis that developed under MTX therapy was not different from that occurring as a natural complication of longstanding severe RA.