Remitting seronegative symmetrical synovitis with pitting oedema syndrome with oedematous skin histopathologically characterized by granulomatous change

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome was first described in 1985¹ and is characterized by symmetrical synovitis of acute onset with pitting oedema over the affected joints, especially the dorsum of the hands,² giving them a 'boxing-glove appearance'.³ Its pathogenesis remains to be elucidated, but the association with late-onset rheumatoid arthritis and polymyalgia rheumatica has been suggested. Moreover, the causative roles of paraneoplastic condition, drugs, infection and diabetes mellitus/insulin therapy have been proposed.⁴ This disease usually responds well to low-dose corticosteroids.⁵

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