[Cutaneous polyarteritis nodosa in children: three cases].
BACKGROUND
Polyarteritis nodosa is a necrotizing vasculitis of small and medium-size arteries. The cutaneous form of polyarteritis nodosa follows a chronic course, characterized by recurrent episodes limited to skin, muscles and joints. This entity differs from systemic polyarteritis nodosa in the absence of visceral involvement. This form is rare in children, we describe three cases.


METHODS
We describe three girls with a mean age of 11 years (range: 8-13). They presented painful subcutaneous edematous nodules, arthralgia and fever. Physical examination revealed livedo reticularis (2 cases) and pharyngeal infection (1 case). Laboratory findings showed an inflammatory syndrome. Skin biopsy supported diagnosis of polyarteritis nodosa. The course was characterized by periods of remission disrupted by exacerbations, well controlled by salicylotherapy, colchicine, dapsone or penicillin. Corticosteroid therapy was used only for invalidating symptoms. There was no systemic involvement after 2, 5 and 6 years of follow up.


CONCLUSIONS
Cutaneous polyarteritis nodosa in children must be suspected in presence of fever, subcutaneous nodules, livedo reticularis and arthralgia. Prognosis is usually benign, so we recommend no aggressive treatment. In view of the tendency to relapse, long-term follow-up is appropriate, before confirming diagnosis.
Assicot
C
C
Service de Dermatologie, Hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris Cedex 10, France.
Bourrat
E
E
Prigent
F
F
Moraillon
I
I
Vignon
M-D
MD
Triller
R
R
Rybojad
M
M
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D003078:Colchicine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use; D010488:Polyarteritis Nodosa / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D012008:Recurrence; D012867:Skin / Q000473:pathology; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010406:Penicillins; D003622:Dapsone; D003078:Colchicine
Périartérite noueuse cutanée de l'enfant: trois cas.