Problem: Article: These lumps are rheumatoid nodules, also known as subcutaneous (or under the skin) nodules. Seen in approximately 30% of cases, these lumps typically have diameters of less than 5 millimeters, ranging in size from small pea size to lemon sized lumps. They are usually found on the forearms, elbows, fingers joints, knees, bottom of feet/heel, the back of the hands, back of the head, the ear regions and inside the nose.,, These lumps are usually not painful, but they can be painful if the overlying skin becomes infected or ulcerated. The lumps will be the color of your skin. They are usually movable when applying pressure to them and feel doughy or firm. This is inflammation of the small and medium sized blood vessels of the skin cause by our body's immune system. Up to 5.4% of people with longstanding/severe RA will experience rheumatoid vasculitis. It can affect many body parts and organs, but the skin is by far the most common site. The following are signs of rheumatoid vasculitis: Purpura: Look for bruising of the skin known as purpura. Since the blood vessels are damaged, blood can leak out causing bluish or dark discoloration that resembles bruises. Digital ischemia: The inflammation can lead to obstruction of blood vessels, which can be seen on the fingers as digital ischemia. When this happens, the fingers affected will turn dark and may become necrotic or gangrenous. Ulcers: This is a superficial hole on the skin. Look for open sores or ulcers on the skin due to inflammatory obstruction of blood vessels. Gangrene: Severely obstructed blood vessels can cause the affected areas skin to die and turn black or necrotic. When this happens, you may feel that the skin sounds crumply when applying pressure. You may also see pus oozing from the area, which is caused by bacteria growth from dead tissue. There may also be a foul smell and possibly pain at the site., Nail fold infarcts: These are small vessels obstructed around the area of the nail or fingertips. Since these vessels are really small, you may see small red or dark dots on the finger pads around the nail. The activation of our immune system's white blood cells (neutrophils) infiltrates all layers of our skin, including the epidermis (outer layer) and dermis (inner layer). There are many diseases associated with this process that falls under neutrophilic dermatosis, some more common than others. Two conditions with this underlying disease process are known as pyoderma gangrenosum and sweet's syndrome. Pyoderma gangrenosum is characterized by painful, enlarging necrotic ulcers (open sores) with bluish undermined borders surrounded by a diffuse red rash. Sweet's syndrome is also known as "acute febrile neutrophilic dermatosis." The symptoms include fever, neutrophil inflammation, and painful plaques on the skin. There is also a diffuse underlying red rash that can appear on the arms, back, face and neck. The skin in this condition may peel or slough off. It is rarely seen in patients with rheumatoid arthritis., If you suspect rheumatoid arthritis, visit your doctor to get a diagnosis and discuss diagnostic tests and severity of your rheumatoid arthritis. This will help you get the appropriate treatment for your condition. RA is a systemic disease which includes the skin. Treating the RA can drastically improve skin systems. Many of these treatments are used for RA and the skin disorders. Therefore, you should expect an overlap of treatment medications. The most important step is to seek expert advice with regards to diagnosing and testing for RA. Once diagnosis is confirmed, management of RA can help prevent these skin diseases.
Summary: Look for firm, circular lumps under the skin. Examine your skin for rheumatoid vasculitis. Look for symptoms of neutrophilic dermatosis. Make an appointment with your doctor. Diagnose and treat RA to improve other skin disorders.

In one sentence, describe what the following article is about: Dogs learn best through positive reinforcement and they quickly learn the best way to get it. Every time your dog is able to go to the bathroom in his designated spot, reward him with a little treat, lots of praise, and a scratch on the head. You can, of course, reward your dog for other things, like learning how to sit and stay. All good behavior should be rewarded. When you're treating your dog for going to the bathroom in his spot, give him a treat and praise right after he finishes relieving himself. Don't give it too early or too late, or he won't associate it with going to the bathroom in the right spot. Some people have had success using the bell method instead of a treat. When your dog goes to the bathroom in his spot, you ring a bell or pleasant-sounding chime as part of his reward. The dog will come to look forward to the sound of the chime, which should only be used in this specific situation. The drawback here is that, eventually, you won't want to keep using a chime or bell every time your dog goes to the bathroom. Initially phasing it out might be confusing to the dog. Whenever you're taking your dog to the bathroom or talking about it, keep your voice light and pleasant. Never raise your voice or take on a menacing tone, because your dog will start to associate his bodily functions with punishment and fear. If your dog makes a mess inside, you can withhold praise, but don't yell at the dog or make him feel ashamed. If using verbal cues, such as "outside", "go potty", or "good dog" be consistent. The repetition of these words along with the action and environment will reinforce where you want your dog to relieve himself. Dogs don't respond well to punishment. It scares them and instead of learning to perform well for you, they learn to fear you. Never yell, hit, or do anything that could cause your dog to feel afraid. Do not rub your dog's face in his mess. Contrary to some beliefs, this does not teach a dog not to go to the bathroom in the house. The dog will not understand what you're doing and you'll just end up scaring him.
Summary:
Give your dog treats and praise each time he successfully goes outside. Time the reward correctly. Consider using a bell or chime to aid in training. Keep your voice and manner light and friendly. Never punish the dog for making a mess.