A challenging path before the Rhupus diagnosis: A case report at the Dermatology Hospital of Bamako

Abstract

Rhupus syndrome, a rare overlap of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), presents significant diagnostic challenges due to its polymorphic clinical features. In this case report, we describe a 50-year-old Malian woman who experienced intermittent hand pain and facial lesions over five years. Initially, she self-treated her symptoms as dermatophytosis, but after five years, more severe symptoms, including deformities in the fingers, photosensitivity, and polyarthralgia, prompted further investigation. Laboratory tests revealed positive autoantibodies, including anti-nuclear and anti-cyclic citrullinated peptide (CCP) antibodies, confirming a diagnosis of Rhupus syndrome. Dermatological treatment with corticosteroids and topical dermocorticoids led to significant improvement in both cutaneous and rheumatological symptoms within three weeks. Rhupus syndrome is a challenging condition due to its complex overlap of RA and SLE, often resulting in delayed diagnosis. This case highlights the importance of early recognition of autoimmunity in patients presenting with atypical dermatological and rheumatological manifestations, facilitating timely intervention and better patient outcomes.