AbstractIntroduction: Rheumatologists are well versed with the clinical
syndrome of polyarteritis nodosa (PAN) involving medium sized muscular
arteries of the kidneys and other internal organs. However, they may not
be so well acquainted with a rarer similar disorder known as cutaneous
polyarteritis nodosa (cPAN). This latter condition is rare and involves
neutrophilic vasculitis of medium-sized arteries in the reticular dermis
and subcutaneous tissue only. It is distinct from systemic polyarteritis
nodosa (sPAN) because of the lack of internal organ involvement.
Uncertainty exists whether the two conditions are different entities or
on the same scale of vasculitis. Milder forms of cutaneous polyarteritis
nodosa resolve with nonsteroidal anti-inflammatory medications, whereas
more severe refractory cases, often require corticosteroids and
immunosuppressives.Case presentation: We present two cases of cutaneous
polyarteritis nodosa that reflect the gamut of this disorder. In our
first case which followed a benign clinical course, a 34-year-old
Filipino female presents with bilateral tender red nodules that resolved
following initiation of prednisone and methotrexate. In our second case
which featured a significant delay in diagnosis, a 55-year-old man with
a five-month history of right lower limb ulcers with associated right
common peroneal neuropathy was commenced on prednisone and methotrexate
but was left with scarring and permanent peripheral nerve deficit.Conclusions: The two cases highlight the condition, informs the
reader and expands the reported experience of cutaneous polyarteritis
nodosa which is a rare condition encountered in clinical practice.
Abbreviations. cPAN, cutaneous polyarteritis nodosa; sPAN, systemic
polyarteritis nodosa.
Key words. Polyarteritis nodosa, cutaneous polyarteritis nodosa,
vasculitis, medium vessel vasculitis, case report