PCMS physician's update (fall to early winter 2013):
The patient was diagnosed as rheumatoid arthritis
during her first presentation to PCMS (at the time of Final MBBS
University exams Spring 2013) and radiology of her hands revealed
significant erosions. She was started on DMARDs (Methotrexate and
Chloroquin) along with bridge therapy with prednisolone. Although the prednisolone was stopped on her subsequent prescriptions (last she was seen here twice on summer of 2013) and currently it seems
she is still on prednisolone and examination reveals acneiform lesions
and facial swelling suggestive of iatrogenic Cushing's. This time her
steroids were put on a tapering dose again and she was counseled on regular follow up (and this web based record was created to facilitate the same). She was continued on her earlier DMARDs and NSAIDs sos.