[Adult cutaneous periarteritis nodosa and dental infections. Role of streptococci].
BACKGROUND
Periarteritis nodosa can be associated with streptococcal infections in children. We report two cases of adult cutaneous periarteritis nodosa that disappeared after the treatment of dental infection.


METHODS
A 23-year-old woman presented with necrotic ulceration on the legs for 6 months, with a histology of necrotizing vasculitis. Many sites of dental infections could be noted. Immunological data were negative and so were serologies of hepatitis. Corticosteroid therapy failed. The teeth removal with antibiotic therapy allowed the disappearance of cutaneous lesions in a month. A 26-year-old woman was hospitalized for growing thin, fever, diffuse arthralgia and myalgia and cutaneous nodules on the legs with necrotizing vasculitis on dermal vessels at histological analysis. The biology showed no pecularity. Radiography of the teeth showed many dental infection sites. The removal of six teeth with antibiotic therapy led to the disappearance of vasculitis in 6 weeks.


CONCLUSIONS
The search for an infectious problem is important when vasculitis is diagnosed, in particular periarteritis nodosa. The treatment of dental infection could occasionally mean avoiding immunosuppressive therapy in certain cases.
Lévêque
L
L
Service de médecine interne et maladies systémiques, hôpital Général, CHU, 3, rue du Faubourg-Raines, 21033 Dijon, France.
Turcu
A
A
Bielefeld
P
P
Gresset
A C
AC
Duong
M
M
Friedel
J
J
Besancenot
J F
JF
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007239:Infections; D007866:Leg / Q000473:pathology; D009336:Necrosis; D010488:Polyarteritis Nodosa / Q000209:etiology* / Q000473:pathology; D014076:Tooth Diseases / Q000150:complications*; D014657:Vasculitis / Q000209:etiology* / Q000473:pathology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents