Cutaneous Polyarteritis Nodosa: Uncommon and Rare Form of Cutaneous Vasculitis

Open access

Abstract

Cutaneous polyarteritis nodosa (CPAN) is a variant of polyarteritis nodosa that is limited primarily to the skin. It is a chronic recurrent disorder characterized by the presence of nodular lesions with or without ulceration on the distal third of the lower limbs. Nodular vasculitis and thrombophlebitis can be clinically or pathologically mistaken for CPAN. We present a case of a 51-year-old woman with painful nodules on the lower limbs. Some of the nodules were ulcerated. Histopathological examination of a nodule on deep incisional biopsy revealed fibrinoid necrosis of a medium-sized artery in the subcutis along with perivascular mixed infiltrate. The patient did not have any symptoms or signs of internal organ involvement. The possible etiological factor has not been detected. The patient was treated with oral prednisone 0.5 mg/kg/day and dapson 150 mg/day. Over the one-year follow-up the lesions showed regression, with one minimal relapse which resolved after the short course of oral prednisone.

1. Sunderkötter CH, Zelger B, Chen KR, Requena L, Piette W, Carlson JA, et al. Nomenclature of cutaneous vasculitis: dermatologic addendum to the 2012 Revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheumatol. 2018;70(2):171-84.

2. Ishiguro N, Kawashima M. Cutaneous polyarteritis nodosa: a report of 16 cases with clinical and histopathological analysis and a review of the published work. J Dermatol. 2010;37(1):85-93.

3. Morgan AJ, Schwartz RA. Cutaneous polyarteritis nodosa: a comprehensive review. Int J Dermatol. 2010;49(7):750-6.

4. Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology. 2010;56(1):3-23.

5. Subbanna PKA, Singh NV, Swaminathan RP. Cutaneous polyarteritis nodosa: a rare isolated cutaneous vasculitis. Indian Dermatol Online J. 2012;3(1):21-4.

6. Lindberg K. A contribution to the knowledge of periarteritis nodosa. J Intern Med. 1931;76:183-225.

7. Furukawa F. Cutaneous polyarteritis nodosa: an update. Ann Vasc Dis. 2012;5(3):282-8.

8. Requena L, Yus ES. Panniculitis. Part I. Mostly septal panniculitis. J Am Acad Dermatol. 2001;45(2):163-83.

9. Carlson JA, Chen KR. Cutaneous vasculitis update: neutrophilic muscular vessel and eosinophilic, granulomatous, and lymphocytic vasculitis syndromes. Am J Dermatopathol. 2007;29(1):32-43.

10. Bansal NK, Houghton KM. Cutaneous polyarteritis nodosa in childhood: a case report and review of the literature. Arthritis. 2010;2010:687547.

11. Bauza A, Espana A, Idoate M. Cutaneous polyarteritis nodosa. Br J Dermatol. 2002;146(4):694-9.

12. Al-Daraji W, Gregory AN, Carlson JA. “Macular arteritis”: a latent form of cutaneous polyarteritis nodosa? Am J Dermatopathol. 2008;30(2):145-9.

13. Lee JS, Kossard S, McGrath MA. Lymphocytic thrombophilic arteritis: a newly described medium-sized vessel arteritis of the skin. Arch Dermatol. 2008;144(9):1175-82.

14. Culver B, Itkin A, Pischel K. Case report and review of minocycline-induced cutaneous polyarteritis nodosa. Arthritis Rheum. 2005;53(3):468-70.

Serbian Journal of Dermatology and Venereology

The Journal of Serbian Association of Dermatovenereologists (SAD)

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 79 79 27
PDF Downloads 63 63 20