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There was a history of general malaise, fever and lethargy for 5\u2009days prior to the swelling of the hands. On examination, the upper limbs were swollen to the elbow bilaterally. Painful erythematous nodules were noted on the dorsal and palmar aspects of the hands and violaceous periungual discolouration was observed on the right fourth and fifth fingers. Prednisolone was commenced resulting in a dramatic resolution of the articular and cutaneous manifestations within 3\u2009weeks.<\/jats:p>","DOI":"10.1136\/bcr-2019-234197","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T06:19:27Z","timestamp":1587622767000},"page":"e234197","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Remitting seronegative symmetric synovitis with pitting edema (RS3PE) with painful erythematous nodules"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2683-9499","authenticated-orcid":false,"given":"Nicholas Kevin","family":"Laidler","sequence":"first","affiliation":[{"name":"Dermatology Department, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Delaney","sequence":"additional","affiliation":[{"name":"Dermatology Department, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,4,22]]},"reference":[{"key":"2025082702361127000_13.4.e234197.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03360190069027"},{"key":"2025082702361127000_13.4.e234197.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-011-1849-3"},{"key":"2025082702361127000_13.4.e234197.3","unstructured":"Karmacharya P , Donato A , Aryal M , et al . 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