title: [Cutaneous polyarteritis nodosa--is it really benign?].
abstract: Polyarteritis nodosa (PAN) is a multi-system disease, characterized by necrotizing vasculitis of medium-sized arteries that may affect any organ system. Cutaneous PAN is the cutaneous limited form of PAN. It affects 10% of all cases of PAN and usually demonstrates a benign and chronic course. We hereby describe a 47-year-old female with diabetes mellitus who presented with painful ulcers on both legs. The clinical and histological findings were consistent with PAN. A thorough investigation ruled out systemic PAN and cutaneous PAN was determined. Despite intensive therapies including corticosteroids and azathioprine, marked progression of the ulcers was noted and large areas of necrosis appeared. The patient underwent above-knee amputation of both legs and eventually died in less than three years. Although cutaneous PAN is known to have a benign and chronic course, we have presented an unusual progressive and severe course that resulted in the death of the patient.
authors: Department of Dermatology and Venereology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. eransha@clalit.org.il
authors: Eran
authors: E
authors: Shavit
authors: Amir
authors: A
authors: Horev
authors: Eitan
authors: E
authors: Berman
authors: Sima
authors: S
authors: Halevy
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects / Q000379:methods; D001158:Arteries / Q000473:pathology*; D001379:Azathioprine / Q000008:administration & dosage*; D001706:Biopsy; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007871:Leg Ulcer / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000601:surgery*; D010488:Polyarteritis Nodosa / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D011241:Prednisone / Q000008:administration & dosage*; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology / Q000503:physiopathology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone