Cutaneous polyarteritis nodosa: A case report

Abstract

Cutaneous polyarteritis nodosa is a rare vasculitis of childhood relating to small-to-medium-sized arteries. Its etiology is unknown. Clinical manifestations include tender subcutaneous nodules, livedo reticularis, cutaneous ulcers and necrosis. Although it is distinct from systemic polyarteritris nodosa in that it lacks significant internal organ involvement, extra-cutaneous manifestations may be evident. The diagnosis is by skin biopsy as there is no other specific serological tests and characteristic pathologic feature is a leukocytoclastic vasculitis in the small to medium-sized arterioles of the dermis with or without fibrinoid necrosis. Mild cases may resolve with nonsteroidal anti-inflammatory drugs. If more severe, treatment with systemic corticosteroids generally achieves adequate response. We report a 10 year old girl with cutaneous PAN, who presented to us with arthralgia and swelling of left knee joint and both ankle joints and fever, with multiple tender subcutaneous nodules on both upper and lower limbs.