Cutaneous polyarteritis nodosa presented with digital gangrene: a case report.
Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown etiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremity. Arthralgia, myalgia, peripheral neuropathy, and constitutional symptoms such as fever and malaise may also be present. We describe a 34-yr-old woman presented with severe ischemic change of the fingertip and subcutaneous nodules without systemic manifestations as an unusual initial manifestation of CPAN. Therapy with corticosteroid and alprostadil induce a moderate improvement of skin lesions. However, necrosis of the finger got worse and the finger was amputated.
Choi
Seung Won
SW
Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Dong-gu, Ulsan, Korea. choisw@uuh.ulsan.kr
Lew
Sogu
S
Cho
Sung Do
SD
Cha
Hee Jeong
HJ
Eum
Eun A
EA
Jung
Hyun Chul
HC
Park
Jae Hoo
JH
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000527:Alprostadil / Q000627:therapeutic use; D000671:Amputation, Surgical; D005260:Female; D005385:Fingers; D005734:Gangrene / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017445:Skin Diseases, Vascular / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D014665:Vasodilator Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D014665:Vasodilator Agents; D000527:Alprostadil