[Cutaneous periarteritis nodosa resistant to combined corticosteroids and immunosuppressive agents. Efficacy of treatment with intravenous immunoglobulins].
BACKGROUND
Cutaneous polyarteritis nodosa is a subset of polyarteritis nodosa (PAN) characterized by a good prognosis because of the absence of severe visceral involvement. Dapsone, colchicin, non steroidal anti-inflammatory drugs are the first line treatments of cutaneous PAN. Corticosteroids are an alternative therapy.


METHODS
A case of cutaneous PAN followed for 6 years is reported. Dapsone, colchicin, corticosteroid and cyclophosphamide have failed to control cutaneous lesions. Intravenous immunoglobulins 400 mg/kg/d five day monthly for 5 months was successful, but a cutaneous relapse occurred 3 months later which was another time controlled with intravenous immunoglobulins.


CONCLUSIONS
Some cases of necrotizing vasculitis have been treated with intravenous immunoglobulins. This is the first reported case of cutaneous PAN treated with intravenous immunoglobulins. Because of the lack of controlled studies, the indications of intravenous immunoglobulins in vasculitis are restricted to those resistant to corticosteroids and immunosuppressive therapy.
Machet
L
L
Service de Dermatologie, CHU Trousseau.
Vincent
O
O
Machet
M C
MC
Barruet
K
K
Vaillant
L
L
Lorette
G
G
D003520:Cyclophosphamide / Q000627:therapeutic use; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone
Periarterite noueuse cutanee resistante aux corticoides et immunosuppresseurs. Efficacite du traitement par immunoglobulines intraveineuses.