title: Cutaneous polyarteritis nodosa successfully treated with topical diflucortolone valerate: a case report & review of the literature.
abstract: Cutaneous Polyarteritis Nodosa (cPAN) was first described in 1931. cPAN is considered a rare disease, its true incidence is unknown. The age of onset is diverse. Most studies have shown no significant gender predominance. cPAN presents with distinct skin findings, such as a maculopapular rash, subcutaneous nodules, livedoid vasculitis, panniculitis, ischemic finger lesions, or erythematous patchy rash. Etiology is unclear. It is still believed to be an immune complex-mediated disease, although a possible mechanism recently proposed relates a familial form of the disease to impaired activity of Adenosine Deaminase 2. cPAN may reflect an underlying disease, infection or medical treatment. There is no consensus as to initial treatment, dosage and length of treatment. Patients with constitutional symptoms, visceral involvement, a more severe course of the disease, or high acute phase reactants, were treated mainly with systemic corticosteroids and/or cytotoxic agents for varying durations. However, persistence of cutaneous lesions has been documented. We describe a 14 year old male suffering from persistent cPAN, with no constitutional symptoms or involvement of internal organs. The patient was treated with a local corticosteroid-based ointment during exacerbations, until complete remission. Although reported in only one study, treatment with topical corticosteroid compound may result in significant improvement or complete regression of skin lesions in cPAN patients.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Tel Aviv University, Sackler School of Medicine, Petach Tikvah, Israel.
authors.forename: Ruby
authors.initials: R
authors.lastname: Haviv
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Tel Aviv University, Sackler School of Medicine, Petach Tikvah, Israel ; Department of Pediatrics Children's Hospital at, Montefiore, New-York City, NY USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Capua
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Tel Aviv University, Sackler School of Medicine, Petach Tikvah, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center of Israel, Tel Aviv University, Sackler School of Medicine, Petach Tikvah, Israel.
authors.forename: Liora
authors.initials: L
authors.lastname: Harel
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001706:Biopsy; D004060:Diflucortolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010488:Polyarteritis Nodosa / Q000188:drug therapy* / Q000473:pathology; D012867:Skin / Q000187:drug effects / Q000473:pathology; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; C013486:diflucortolone valerate; D004060:Diflucortolone
keywords: CPAN; Corticosteroid; Cutaneous polyarteritis nodosa; Diflucortolone valerate; Periarteritis; Topical treatment