Paulo Ricardo Criado1, Gabriela Franco Marques2, Thamara Cristiane Alves Batista Morita2, Jozélio Freire de Carvalho3. 1. Dermatology Division, Hospital das Clínicas da Faculdade de Medicina de São Paulo (HC-FMUSP), São Paulo, São Paulo, Brazil. Electronic address: prcriado@uol.com.br. 2. Dermatology Division, Hospital das Clínicas da Faculdade de Medicina de São Paulo (HC-FMUSP), São Paulo, São Paulo, Brazil. 3. Rheumatology Division, Aliança Medical Center, Salvador, Bahia, Brazil.
Abstract
UNLABELLED: Cutaneous polyarteritis nodosa (CPAN) is a rare disease that affects small and middle caliber vessels of the deep dermis and subcutaneous tissue and its etiopathology remains yet to be understood. METHODS: Retrospective review of twenty two cases diagnosed as CPAN and confirmed by skin biopsy over the last 11 years was evaluated in our department. RESULTS: We found predominance in white woman, mean age of 39.4 years, showing no comorbidities in most of our sample. Mean follow-up time was 58 months. The most frequent cutaneous manifestations were ulcers, livedo racemosa, subcutaneous nodules, atrophie blanche lesions and purpuras; with lower limb involvement in all cases, however other areas were also involved. The main regional symptoms were pain and paresthesia, while systemic complaints were absent in the majority of cases. Mononeuritis multiplex was identified in a quarter of our sample. Most of the laboratory findings were non-specific. There was evidence for previous contact with Mycobacterium tuberculosis in 46.1% of cases which were tested for purified protein derivative (PPD) test. In our patients the disease course was benign and without complications, and systemic polyarteritis nodosa did not develop in any patient. CONCLUSIONS: An extensive work-up including laboratory tests on autoimmunity and thrombophilic factors and investigation of infectious diseases, especially previous contact with tuberculosis agent, should be part of the CPAN investigation.
UNLABELLED: Cutaneous polyarteritis nodosa (CPAN) is a rare disease that affects small and middle caliber vessels of the deep dermis and subcutaneous tissue and its etiopathology remains yet to be understood. METHODS: Retrospective review of twenty two cases diagnosed as CPAN and confirmed by skin biopsy over the last 11 years was evaluated in our department. RESULTS: We found predominance in white woman, mean age of 39.4 years, showing no comorbidities in most of our sample. Mean follow-up time was 58 months. The most frequent cutaneous manifestations were ulcers, livedo racemosa, subcutaneous nodules, atrophie blanche lesions and purpuras; with lower limb involvement in all cases, however other areas were also involved. The main regional symptoms were pain and paresthesia, while systemic complaints were absent in the majority of cases. Mononeuritis multiplex was identified in a quarter of our sample. Most of the laboratory findings were non-specific. There was evidence for previous contact with Mycobacterium tuberculosis in 46.1% of cases which were tested for purified protein derivative (PPD) test. In our patients the disease course was benign and without complications, and systemic polyarteritis nodosa did not develop in any patient. CONCLUSIONS: An extensive work-up including laboratory tests on autoimmunity and thrombophilic factors and investigation of infectious diseases, especially previous contact with tuberculosis agent, should be part of the CPAN investigation.
Authors: Thâmara Cristiane Alves Batista Morita; Paulo Ricardo Criado; Roberta Fachini Jardim Criado; Gabriela Franco S Trés; Mirian Nacagami Sotto Journal: An Bras Dermatol Date: 2020-05-24 Impact factor: 1.896