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Author: Dr Jenny Chung, Dermatology Registrar, Auckland District Health Board, Auckland, New Zealand. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. July 2020.
Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare rheumatic disease. It is also referred to as puffy oedematous hand syndrome and distal extremity swelling with pitting oedema .
RS3PE is generally diagnosed in older men in their 70s and 80s [2,3].
Although the cause of RS3PE is unknown, the following may contribute to the disease.
The distinguishing feature of RS3PE is peripheral oedema.
The complications of RS3PE relate to pitting oedema, and can include:
RS3PE is a clinical diagnosis with the following features [4,5]:
While RS3PE is rare, there are other diseases that present with rapid peripheral oedema and symmetrical synovitis. These include the following conditions.
The treatment for RS3PE is oral steroids with a typical starting dose of 10–20 mg of prednisone per day. Prognosis is reported to be good [2,5].
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