Abstract
Background Tender patches in the soft tissues have been noted in many rheumatic conditions and given various names, including ‘rheumatic patches’. Treatment by intradermal sodium salicylate has been proposed. We have done a preliminary investigation of this method in fibromyalgia.Methods 11 unselected fibromyalgia sufferers were examined for rheumatic patches. When found, the areas were treated with 0.7% intradermal sodium salicylate. Representative areas of skin were examined histologically, with and without treatment.Findings Rheumatic patches were found in the skin in the painful areas in all patients. 9/11 patients reported worthwhile symptomatic improvement after treatment. Post-treatment sections suggest that benefit is obtained by physical distension of the dermal tissues.Interpretation This treatment deserves to be tested in a controlled clinical trial. It seems that at least some of the pathology in fibromyalgia lies in the skin, though central hypervigilance for pain is also involved in pathogenesis.
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