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Sir, Rheumatoid nodules have been reported to occur in about 20% of patients with chronic rheumatoid polyarthritis (1, 2). In the recent literature, a correlation between treatment of rheumatoid arthritis with methotrexate and the development or worsening of rheumatoid nodules has been suggested (2 ± 4). We describe here the explosive deterioration of rheumatoid nodules during the course of methotrexate treatment for rheumatoid polyarthritis in a 63-year-old woman and discuss current aspects of possible pathogenetic mechanisms as well as therapeutic options for methotrexate-induced rheumatoid nodules.

Rheumatoid Nodules Developing under Methotrexate Treatment for Rheumatoid Arthritis