Dermatology-Rheumatology Connective Tissue Disease Program

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.
Refer a patient

Contact us: 617-726-2914


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.

Founded 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.

Dermatologist, Flavia Fedeles, MD joined the Connective Tissue Disease  Program in 2018.  Prior to coming to Mass General, Dr. Fedeles was an attending dermatologist at the Lahey Clinic, where she practiced dermatology and was involved with teaching of Harvard Dermatology residents and Nurse Practitioners. She also completed a fellowship in Dermatopathology at Tufts University Medical School.   Dr. Fedeles is accepting new patients and she is fluent in French and Romanian.

Conditions We Treat

  • 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
  • Suspicion of a connective tissue rash
  • Neutrophilic dermatoses (PNGD, EED)
  • 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. Fedeles, including specific skin exam techniques for evaluating disease risk and severity in autoimmune 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. Fedeles 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 for rheumatic diseases and is ranked highly by U.S. News & World Report. Members of the Rheumatology Unit participating in this clinic are known nationally for their clinical and research leadership, including:

To Refer a Patient

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.

Conditions & Diseases

  • 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

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


Contact Us

Dermatology-Rheumatology Connective Tissue Disease Program

Massachusetts General Hospital, Dermatology

50 Staniford Street, Suite 807 Boston, MA 02114
  • Near Public Transit
  • Accessible
  • Phone: 617-726-2914
  • Fax: 617-726-7768


  • 9am-5pm

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

Refer a patient

Contact us: 617-726-2914

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