Abstract: A 56-year-old female presented with swelling on the right upper for 10 years, which was aggravated with skin hypertrophy and hardening for more than 7 years. She had a history of rheumatoid disease for 12 years. Physical examination showed diffuse nonpitting edema below the elbow on the right upper extremity, the skin was hypertrophied and hardened with some brown keratotic plaques. Pathological examination showed mild papilloma-like hyperplasia of the epidermis, scattered pigment cells in the superficial dermis, thickened collagen fibers, and infiltration of lymphocytes, plasma cells and neutrophils between collagens and perivascular. The diagnosis of rheumatoid arthritis combined with lymphedema keratoderma was made.

Key words: lymphedema keratoderma, rheumatoid arthritis, synovial hyperplasia