Arthritis and Hepatitis

To the Editor: Recently, we saw a patient with arthritis and HAA-positive hepatitis similar to those described by Alpert et al. in the Journal.¹ Our patient, an 18-year-old white serviceman, had a maculopapular rash and skin nodules reminiscent of the case referred to in the editorial by Dr. Koff.² The arthritis was unilateral, involving a proximal interphalangeal joint, and the skin nodules were bilateral, involving flexor and extensor aspects of the forearms. The initial serum complement level was 50 mg per 100 ml (normal, 145 ± 22 mg per 100 ml) and was associated with five Yale units.