Rheumatology Department, Complejo Asistencial Universitario de León, León, SpainSpain
Anatomical Pathology Department, Complejo Asistencial Universitario de León, León, SpainSpain
Also available as PDF (figures and tables appear in the PDF).
Cutaneous polyarteritis nodosa is a rarer variant of classic polyarteritis nodosa with unknown etiopathogenesis. It presents with skin, articular and nervous involvement, after systemic involvement is ruled out. This work reports the case of a 41-year-old male patient diagnosed with cutaneous polyarteritis nodosa with skin lesions, polyarthralgia and sensory axonal polyneuropathy.
Keywords: Skin; Polyarteritis; Vasculitis; Biopsy; Immunofluorescence; Histology; Skin; Polyarteritis; Vasculitis; Biopsy; Immunofluorescence; Histology
We hereby present a case of cutaneous polyarteritis nodosa in
an adult patient. Diagnosis of PNC may be challenging as it may
share similarities with polyarteritis nodosa. Most cases respond to
treatment with corticosteroids, however, few cases relapse after
tapering doses and require immunosuppressive agents and bio-
logic therapy.
• CPAN is a rare and benign cutaneous vasculitis of unknown
ethology with chronic and relapsing course distinct from systemic
PAN Based on the patient’s medical history, biopsy and im-
• The diagnosis of CPAN is confirmed by histopathologic examiaging results and pulmonary function tests, systemic involvement
nation of skin biopsy.
was ruled out and the patient was diagnosed with cutaneous poly-
• Treatment with corticosteroids is effective but there are cases arteritis nodosa (CPAN).
of corticosteroid resistant or corticosteroid dependent that require
The patient was started on prednisolone 40 mg dose with immunosuppressive agents or biologic therapy
tapering doses, showing visible improvement of skin lesions and
arthritis and reduction of raised acute-phase reactants. Tapering
beyond 20 mg daily without was not possible which motivated
The authors acknowledge the assistance of study participant, ratreatment with immunosuppressive therapies, including azathio-
diographers, study nurses and laboratory staff who participated in prine and methotrexate, however, no improvement was noted. In-
the study. The study was conducted without any financial support. duction treatment with rituximab was administered for 4-weeks,
showing rapid and complete resolution of symptoms and skin le-
sions.
Patient consent was given with purposes of writing this article.
Polyarteritis nodosa is a vasculitis of small and medium vessels.
The cutaneous form does not associate multiorgan involvement
and has a favourable prognosis. It is more frequently associated
with paediatric patients and may be associated with infections,
autoimmune diseases and pharmacological treatment.5
The authors declare that they have no conflicts of interest. Osteol Rheumatol Open J. 2020; 3(1): 25-27. doi: 10.17140/ORHOJ-3-115