Dermatology-Rheumatology Connective Tissue Disease Program

The Dermatology-Rheumatology Connective Tissue Disease Program provides comprehensive care for patients with autoimmune skin and joint disease such as dermatomyositis, lupus and scleroderma.

Dermatologist, Gideon P. Smith, MD and Rheumatologist,Sheila L. Arvikar, MD

Dermatologist Gideon P. Smith, MD and rheumatologist Sheila L. Arvikar, MD examine a patient at the same visit.

The Dermatology-Rheumatology Connective Tissue Disease Program is a collaboration between Massachusetts General Hospital Departments of Dermatology and Rheumatology. Autoimmune diseases such as lupus, scleroderma or dermatomyositis significantly impact both the skin and musculoskeletal system. Improved management of these conditions comes from periodic evaluation by both a dermatologist and a rheumatologist.

Expert Care

Patients are seen by a dermatologist and a rheumatologist at the same time in the Dermatology-Rheumatology Connective Tissue Disease Program. This enables immediate interaction between the healthcare providers ensuring clear communication; development of a unified therapy plan; and ensures coordination of care. Additionally, this service benefits patients by minimizing blood draws and the number of visits.

Led by Dr. Gideon P. Smith, an expert in this field, the Dermatology-Rheumatology Connective Tissue Disease Program provides comprehensive care for patients with skin problems associated with arthritic related diseases such as rheumatoid arthritis, lupus, scleroderma, and connective tissue disease. Dr. Smith completed a Sulzberger Fellowship at New York University Langone Medical Center where he specialized in psoriatic arthritis and scleroderma. He received a number of awards for recognition of his work and has expertise in connective tissue disease, dermatology-rheumatology, psoriatic arthritis, and scleroderma. Dr. Smith is fluent in Spanish and is accepting new patients.

  • Eosinophilic Fasciitis
  • Calcinosis cutis
  • Granulomatous dermatitis with arthritis
  • Dermatomyositis or polymyositis
  • Sarcoid
  • Undifferentiated Connective Tissue Disease
  • Mixed Connective Tissue Disease
  • Digital ulceration
  • Urticaria
  • Schnitzler’s syndrome
  • SCLE
  • Discoid Lupus
  • Tumid lupus
  • Cutaneous Vasculitis
  • Livedo reticularis
  • Erythromelalgia
  • Scarring Hair loss with inflammation
  • Suspicion of a connective tissue rash
  • Neutrophilic dermatoses (Pyoderma gangrenosum, Sweet’s syndrome, PNGD)
  • Panniculitis (Erythema Nodosum, lupus panniculitis, erythema induratum)

What to Expect

Since this is a specialty clinic, patients are referred by a healthcare professional.  During an initial consultation, the patient's skin, hair and nails are examined for disease involvement by Dr. Smith including specific skin exam techniques for evaluating disease risk and severity in automimmune disease. The joints and muscles are also evaluated by the rheumatologist attending. Prior blood tests, radiologic studies and skin biopsies, if these have been performed, are evaluated and if necessary additional testing discussed with the patient. Based on the patient's history, overall condition, and degree of immune system compromise, a personalized treatment plan is recommended based on:

1. Cutaneous manifestations of disease in skin hair or nails
2. Joint and muscle manifestations
3. Results of skin biopsy, microscopic evaluation and blood analysis
4. Both the manifestations of the patients autoimmune disease and their overall health and lifestyle

Dr. Smith works closely with Mass General’s Rheumatology Unit to tailor a treatment plan to fit a patient’s unique medical situation. Often patients will have previously received treatments for their underlying disease but which still leave the patient with significant disease-associated problems such as disabling Raynaud’s, progressive skin scarring or hairloss. Our objective is to provide a comprehensive medical approach to all aspects of the patients condition.

Multidisciplinary Care

Massachusetts General Hospital Rheumatology Unit provides expert care fro rheumatic diseases and is ranked 6th in the nation according to U.S. News Reports:  Members of the Rheumatology Unit participating in this clinic are known nationally for their clinical and research leadership, including:

John Stone, MD, MPH, clinical director of rheumatology (lupus and vasculitis)

Janice Lin, MD, MPH

Sheila Arvikar, MD

Sebastian Unizony, MD

Eli Miloslavsky, MD

The Dermatology-Rheumatology Connective Tissue Disease Program is located in the Department of Dermatology, 50 Staniford Street, 8th Floor, Boston. MA


For Mass General Referring Physicians, please refer through the CRMS system.

For Referring Physicians outside of Mass General, please call 617-726-2914 , Press 1 and ask for the Connective Tissue Diseases Coordinator. Or, submit the online referral form and our coordinator will assist you.

Dermatology-Rheumatology Connective Tissue Disease Program
Massachusetts General Hospital
50 Staniford Street, Eighth Floor
Boston, MA 02114


Raynauds Phenomenon

Raynaud's phenomenon or, simply, Raynaud's, is a disorder characterized by decreased blood flow - usually to the fingers, and less frequently to the ears, toes, nipples, knees, or nose.


Scleroderma, also called systemic sclerosis, is a chronic, degenerative disease that affects the joints, skin, and internal organs.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Dermatology-Rheumatology Connective Tissue Disease Program

Massachusetts General Hospital, Dermatology
50 Staniford Street, Suite 807
Boston, MA 02114

Phone: 617-726-2914
Fax: 617-726-7768
Hours: 9am-5pm

Public Transportation Access: yes
Disabled Access: yes

Call 617-726-2914; Press 1 and ask for the Connective Tissue Diseases Coordinator