Benign rheumatoid nodules.

Fifteen asymptomatic children with benign rheumatoid nodules, followed up to 12 years, are described. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression, and frequent recurrence. Granuloma annulare was present in two patients. All 15 children were healthy and free from rheumatoid arthritis, rheumatic fever, or any other recognizable systemic disease at followup and none had positive tests for antinuclear antibodies or rheumatoid factors. Histologically the nodules closely resembled those seen in adult-onset rheumatoid arthritis. Though biopsy may be useful for confirmation of the clinical diagnosis of benign rheumatoid nodules, wide surgical excision, skin grafting, and treatment with medication are unnecessary in this self-limited syndrome.