TY - JOUR T1 - Massive nodulous lesions on hands and feet in a RA patient and improvement under baricitinib treatment JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2020-001493 VL - 6 IS - 3 SP - e001493 AU - Larissa Valor-Méndez AU - Melanie Hagen AU - Arnd Kleyer AU - Bernhard Manger AU - Georg Schett Y1 - 2020/11/01 UR - http://rmdopen.bmj.com/content/6/3/e001493.abstract N2 - Dear Editor,A 58-year-old woman presented with massive nodulous lesions on her hands and feet in our outpatient clinic in spring 2018. She had a history of seropositive erosive rheumatoid arthritis (RA) starting in 2005 with first nodules appearing in 2008. The patient had received sequential treatments with prednisolone, methotrexate 15 mg/week for 4 years and stopped in 2012, leflunomide for 3 years and adalimumab until presentation. Over the years, hand and feet nodules worsened impairing her function. She also developed skin lesions around the nodules leading to severe recurrent local infections requiring surgical removal of some of the nodules, ultimately necessitating the amputation of two digits. At presentation, the patient showed massive nodular deformations and … ER -