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Description
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries, involving multiple organs, with the most frequently affected tissues being skin and peripheral nerves (1). The distinct pearl neckless pattern led to the naming of this condition (2). Cutaneous polyarteritis nodosa (CPAN) is a variant of PAN confined to the skin, muscles and peripheral nerves in the absence of any systemic involvement (1). This rare form of systemic necrotizing vasculitis is limited to the medium-sized arteries of the skinand has a more favorable prognosis (1). PAN is also linked to Hepatitis B(2).The current diagnostic criteria for CPAN were proposed in 2009 by Nakamura et al.and include the presence of cutaneous manifestations and biopsy-proven fibrinoid necrotizing vasculitis of small and medium sized arteries (1). General non-specific symptoms such asthenia, fever, weight loss, myalgia, and arthralgia are frequently the symptoms of PAN (1). Neurological manifestation occur in more than 2/3 of patients, more commonlyas motor and sensory mononeuritis multiplex of the peripheral nerves (1). Peripheral neuropathy is typically distal, asymmetric, and can be rapid-onset, often associated with localized skin edema (1). Skin lesions, including nodules, purpura, necrotic ulcers, and livedo reticularis, are present in half of the patients (1). In cases of cutaneous manifestations suggestive of vasculitis, a skin biopsy is recommended (1). The biopsy should be deep enough to include the dermal layer where medium-sized arteries are located (1). A subset of PAN, known as cutaneous PAN (CPAN) is confined to the skin and requires different management (1).
Publication Date
3-13-2025
Keywords
Polyarteritis nodosa
Disciplines
Podiatry
Recommended Citation
Li E, Toma J. The diagnosis of polyarteritis nodosa in the setting of lower extremity lesions: a case report. Presented at Corewell Health Hospital Farmington Hills 2025 Alvin Yarrows Research Day; 2025 Mar13; Farmington Hills, MI.
Comments
2025 Alvin Yarrows Research Day at Corewell Health Hospital Farmington Hills, Farmington Hills, MI, March 13, 2025.