Cutaneous polyarteritis nodosa

Abstract

A 50-year- old man developed 3 ulcers on the right forearm and one on buttock with well-defined bluish edges, hyperaemic floor studded with yellowish granulation tissue, serous discharge and peripheral papulonodular lesions fixed to underlying tissues. There was off and on fever, myalgia and neuropathy. Skin-colored mobile nodules (1.5x2 cm each) were present, one each on left shoulder and right thigh. Biopsy revealed endothelial proliferation and infiltration of vessel wall with neutrophils along with marked perivascular infiltrate of neutrophils and admixture of macrophages, lymphocytes and plasma cells. Fibrinoid deposits in vessel walls, extravasation of RBCs and necrosis of dermis were also present. Histopathology confirmed clinical diagnosis of cutaneous polyarteritis nodosa (CPN). Patient responded excellently to 50mg of dapsone tid for 4 weeks.