Clinical and Histopathological Study of 24 Cases with Cutaneous Polyarteritis Nodosa

Kim, Young Jin; Lee, Ji Yeoun; Yoon, Tae Young

Abstract

BACKGROUND
Cutaneous polyarteritis nodosa (PAN) is a rare form of vasculitis relating to small-to-medium-sized arteries, it frequently causes impairment and presents a therapeutic challenge. Nevertheless, it remains an understudied disease and only a few clinical studies on cutaneous PAN with small number of patients have been conducted in Korea so far.
OBJECTIVE
The aim of this study is to obtain a better understanding of the clinical and histopathological features for cutaneous PAN.
METHODS
This was a retrospective study of cutaneous PAN observed at our center over an 12-year period. Clinical manifestations and histopathological features of 24 patients with cutaneous PAN were being evaluated.
RESULTS
The ratio of males to females was 1 : 2.42 and the most frequently occurred age group was the third decade. The most commonly involved sites were the lower legs (100%), thighs (37.5%), arms (12.5%) and trunks (8.3%). The most common clinical findings were painful nodules, as seen in 62.5% (reticular erythema in 25%, scattered erythematous patches in 25%, and ecchymotic patches in 4.2%). Erythrocyte sedimentation rates are elevated in 61.9% of 21 patients. Histopathologically, the fibrinoid necrotizing vasculitis of small arteries in the deep dermis and panniculus were observed and the arteries were being classified into 4 stages: the acute stage (3.6%), subacute stage (57.2%), reparative stage (32.1%), and healed stage (7.1%). The most commonly treatment modality was systemic corticosteroids (62.5%). The clinical course was the chronically relapses and our study showed that the cutaneous PAN does not progress to the systemic PAN.
CONCLUSION
This study suggested that the cutaneous PAN has a variable course, with repeated exacerbations, but does not progress to the systemic PAN. And no definitively effective therapy for cutaneous PAN has been established, additional prospective studies are necessary in order to determine the effectiveness of the various treatment modalities.