Case Of Cutaneous Polyarteritis Nodosa Research Articles

Classic polyarteritis nodosa presenting initially as a case of cutaneous polyarteritis nodosa: A case report

Classic polyarteritis nodosa presenting initially as a case of cutaneous polyarteritis nodosa: A case report

Cutaneous polyarteritis nodosa in three patients: disease course and our experience leading to faster remission

We present three new cases of cutaneous polyarteritis nodosa with a follow-up ranging from 38 to 49 months, describing their clinical and histological findings, as well as treatment options leading to sustained remission. All patients met the criteria for diagnosis. The presence of extracutaneous symptoms and laboratory analysis differed among our patients, as did various elements of the workup in comparison to published studies. We concluded that dapsone alone, or in combination with systemic steroids, proved superior and highly effective despite being less frequently used. More aggressive therapy for shorter intervals could lead to quicker remission of cutaneous lesions and symptoms without chronic relapses, which are commonly noted.

A case of cutaneous polyarteritis nodosa complicated by Crohn′s disease

A case of cutaneous polyarteritis nodosa complicated by Crohn′s disease

Gangrenous digital infarcts in a severe case of cutaneous polyarteritis nodosa

Cutaneous polyarteritis nodosa (CPAN) is a rare diagnosis which is distinct from polyarteritis nodosa (PAN). PAN is a medium-vessel vasculitis which can affect multiple organs and classically produces microaneurysms in...

宮古ビデンス・ピローサ<sup>®</sup>茶の飲用が補助療法として奏効した 皮膚型結節性多発動脈炎の 1 例

宮古ビデンス・ピローサ<sup>®</sup>茶の飲用が補助療法として奏効した 皮膚型結節性多発動脈炎の 1 例

A case of cutaneous polyarteritis nodosa with elevated serum interleukin-6 levels complicated by leg arterial stenosis and destructive arthropathy of the left ankle

We report a case of a 60-year-old female with cutaneous polyarteritis nodosa (CPN) of the left ankle, accompanied by elevated serum interleukin (IL)-6 levels. Computed tomographic angiography revealed severe narrowing of medium-sized arteries in her left leg. Destructive arthropathy in the left ankle was identified by X-ray and magnetic resonance imaging. This is the first Japanese case of severe CPN complicated by destructive arthropathy. Quantification of serum IL-6 might be useful in diagnosis and evaluation of CPN.

A case of cutaneous polyarteritis nodosa with elevated serum interleukin-6 levels complicated by leg arterial stenosis and destructive arthropathy of the left ankle

We report a case of a 60-year-old female with cutaneous polyarteritis nodosa (CPN) of the left ankle, accompanied by elevated serum interleukin (IL)-6 levels. Computed tomographic angiography revealed severe narrowing of medium-sized arteries in her left leg. Destructive arthropathy in the left ankle was identified by X-ray and magnetic resonance imaging. This is the first Japanese case of severe CPN complicated by destructive arthropathy. Quantification of serum IL-6 might be useful in diagnosis and evaluation of CPN.

Cutaneous polyarteritis nodosa: A report of 16 cases with clinical and histopathological analysis and a review of the published work

Sixteen cases of cutaneous polyarteritis nodosa referred to our Department from 1985 to 2003 were studied clinically and histopathologically. Laboratory data, treatments and clinical courses were also evaluated retrospectively. All cases had nodules and/or indurated erythemas on their lower extremities. All cases showed necrotizing vasculitis of small muscular arteries in the subcutaneous tissues and/or occlusion of those arteries histopathologically. Fifteen cases also had accumulation of plasma protein in vessels of the dermis and subcutaneous tissues. Laboratory data showed high activity of platelets and coagulation in some cases. Eleven cases had been effectively treated with non-steroidal anti-inflammatory drugs. Eight cases were observed for at least 5 years (the longest for approximately 19 years) and had good prognoses and no systemic involvement. Cutaneous polyarteritis nodosa seems to be a benign disease, and differs from systemic polyarteritis nodosa although their histopathological features are common. Cutaneous polyarteritis nodosa might involve local dysfunction of the circulation from the dermis to the subcutaneous area. A review of the published work shows that the cause(s) of most cases of cutaneous polyarteritis nodosa is unknown, that no controlled trials for treatment of cutaneous polyarteritis nodosa compared to polyarteritis nodosa have been reported, and that no definitively effective therapy for cutaneous polyarteritis nodosa has been established.

A 61‐year‐old man with livedo reticularis

Cutaneous polyarteritis nodosa (PAN) is a rare form ofpolyarteritis involving the deep dermis and panniculus. Itis characterized by livedo reticularis, nodules, and ulcer-ations in more severe disease (1,2). The lower extremitiesare most commonly involved. Constitutional and muscu-loskeletal symptoms and polyneuropathy may be associ-ated findings (2). Underlying systemic disorders may beseen with cutaneous PAN, although in the majority ofcases, it occurs in isolation (2). Here we describe a case ofcutaneous PAN occurring in a patient with natural killer(NK) cell lymphocytosis, an exceedingly unusual combi-nation of two rare diseases.

A case of cutaneous polyarteritis nodosa manifested by spiking high fever, arthralgia and macular eruption like adult-onset Still's disease

A 24-year-old Japanese woman was admitted for investigation of recurrent spiking high fever associated with a macular eruption of the upper extremities associated with fever and polyarthralgia. These symptoms were self-limiting but recurrent and seemed to be consistent with a diagnosis of adult-onset Still's disease (AOSD). However, livedo reticularis was detected on the lower extremities, suggesting the presence of vasculitic disease rather than AOSD. Investigation did not reveal any evidence of visceral involvement. Skin biopsy of the affected lower extremity demonstrated a necrotizing vasculitis of small muscular artery and confirmed a diagnosis of cutaneous polyarteritis nodosa (PAN) rather than AOSD. Treatment with 30 mg of prednisolone daily improved the skin lesions and the recurrent spiking high fever and the arthralgia were resolved. PAN and AOSD are clinically similar, and discrimination may be sometimes difficult. The presence of livedo reticularis and the finding of a characteristic skin biopsy appearance may be diagnostically useful to distinguish PAN from AOSD. Indeed, the clinical features of cutaneous PAN may be more similar to AOSD than systemic PAN, and a skin biopsy may be necessary to distinguish cutaneous PAN from AOSD in some cases.

Suspected white‐tail spider bite and necrotic ulcers

To describe the clinical features, investigation, diagnosis and treatment of ulcers attributed to white-tail (WT) spider bites or necrotic arachnidism. The study was a prospective case series of patients referred to the Hunter Area Toxicology Service (a tertiary referral toxicology unit servicing a population of 500 000) with an ulcer or skin lesion that had been attributed to either a suspected WT spider bite or necrotic arachnidism. Eleven patients with skin lesions or necrotic ulcers were referred between January 2000 and June 2002. In two patients that were inpatients in other hospitals, investigation and follow up was not possible. In both cases there was no history of spider bite and Staphylococcus aureus was cultured. In nine patients, a diagnosis other than spider bite was made following appropriate investigation and follow up, including: (i) two cases of dermatophytoses, (ii) three staphylococcal infections, (iii) one case of pyoderma gangrenosum, (iv) one case of cutaneous polyarteritis nodosa, (v) one case of Nocardia braziliensis and (vi) one infected diabetic ulcer. There was only one case where the person recalled seeing a spider bite them, but the patient did not collect the spider for identification. The median time to diagnosis was 3 weeks (interquartile range: 3-9 weeks) and 3.5 years in one case. Appropriate treatment was initiated once the correct diagnosis was made and all cases resolved. In this series, all cases initially referred as WT spider bites or necrotic arachnidism were found to have alternative diagnoses with appropriate investigations. This demonstrates that spider bites are an unlikely cause of necrotic ulcers and that all ulcers should be properly investigated with bacterial, fungal and mycobacterial cultures and skin biopsy for histopathology.

A case of cutaneous polyarteritis nodosa associated with ulcerative colitis

A case of cutaneous polyarteritis nodosa associated with ulcerative colitis

Cutaneous polyarteritis nodosa of childhood.

The clinical presentation of childhood polyarteritis nodosa (PAN) can range from isolated cutaneous findings to widespread multisystem involvement. Both the systemic and cutaneous forms are known to occur after streptococcal infection. Our purpose was to emphasize the frequent association of childhood cutaneous PAN with antecedent streptococcal infection. We discuss four cases of cutaneous PAN that were associated with streptococcal infection and briefly review the pertinent literature. All patients had evidence of preceding streptococcal infection at the onset of their illness. Although mild systemic symptoms were present in all, their course was benign. The use of nonsteroidal antiinflammatory agents or corticosteroids resulted in clinical improvement. Antibiotic therapy was also used in the treatment of these patients. In children with PAN, evaluation should include laboratory studies to detect streptococcal infection.

Cutaneous polyarteritis nodosa associated with hepatitis B surface antigen

The finding of hepatitis B surface antigen in systemic polyarteritis nodosa is well recognized. We described a case of cutaneous polyarteritis nodosa associated with hepatitis antigenemia and a medium-sized vessel vasculitis on skin biopsy, with no evidence of systemic involvement.