Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient

Round 1

Reviewer 1 Report

1. The topic is of interest but some revisions are needed.

1) The part on genetics should not be included in the introduction and does not add useful information to the rest of the text, at least there.

2) The case presentation is a bit confused. I guess that RA stands for Rheumatoid arthritis and this should be precised. During the presentation of the case, it should be mentioned that the patient was admitted earlier to the Rheumatology department (temporal confusion); the same goes for the description of the Orthopedic problem of the patient, which pops up during the story.

3) Where was the biopsy for the histopathological examination performed?

4) The authors state the patient met SIRS criteria... is SIRS criteria a differential diagnosis? It should be at least briefly stated in the case description

5) the Authors state is uncommon for blood cultures to be positive in sepsis. Considering the non-contiguous distribution of involvement, could an infective endocharditis be suspected? Has the patient undergone an echocardiogram?

6) Considering the important cutaneous manifestations of this case, the differential diagnosis with pyoderma gangrenosum should be discussed

7) Neutrophilic dermatoses are gaining attention from the dermatology community. For example, negativity of the microbiological exams is important in another neutrophilic dermatosis often mistaken for an infectious or neoplastic process, such as erosive pustular dermatosis of the scalp (Michelerio A, Vassallo C, Fiandrino G, Tomasini CF. Erosive Pustular Dermatosis of the Scalp: A Clinicopathologic Study of Fifty Cases. Dermatopathology (Basel). 2021;8(4):450-462.). Other neutrophilic dermatoses should be briefly discussed.

8) What are the other treatments for AAS?

 

Author Response

The response is in attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Reviewer comments

Line	Manuscript	Comments
15	They may be associated with inflammatory bowel disease and autoimmune diseases	English editing is needed
16	We would like to present a case	Not scientific language
20	Despite Covid-29 infection treated with remdesivir	English editing is required in the whole manuscript Abbreviation capital Meaning should be mentioned at the first appearance of the abbreviation
22	AA is a difficult recognize, so practitioners have to be aware 22 of this condition.	The conclusion should mention the association with rheumatoid
23	The examination of the patient was conducted according to the Declaration of 23 Helsinki principles.	It is better to write this sentence under the case presentation section not at the abstract
37	with inflammatory bowel disease	an inflammatory
39	AAS has many features in common with neutrophilic dermatoses and is currently 39	Not appropriate to write a paragraph with only 2 lines
55	We would like to present	Not scientific writing
	Abstract	The most important here is the association between AAS and RA. However, the authors did not refer to that at the introduction
58-67		Re arrange this paragraph as it is confusing
73	extensible surfaces	Extensive
79		The laboratory investigations should be mentioned after this part
102	prednisone 40 mg and pulse with methylprednisolone iv (500 mg every day for 3 102 days) were included in the treatment	Why both oral and in steroids at the same time
106	adalimumab 80 mg was	What is the rationale of adding adalimumab after the improvement of the case
Discussion		Many sentences were written without references
158		The authors mentioned many positive antibodies at the discussion and did not mention that at the case presentation The titre of autoantibodies is very high which necessities exclusion of lupus or overlap syndrome
		The discussion is poor and did not emphasize on the association between rheumatoid and aas

 

 

Author Response

The response is in attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

The reply to the reviewer's comment is to some extent strange to the scientific society . The authors wrote I have corrected in front of each comment.

This reply is not satisfying and not scientific . The authors should follow the scientific rules of writing a reply to reviewers.

 

 

Author Response

Dear Review,

Thank you for your important suggestions and time devoted to my manuscript. I tried to adjusted my manuscript.

Best regards

Agnieszka Owczarczyk-Saczonek

Author Response File: Author Response.pdf

Round 3

Reviewer 2 Report

accept in the present form