ABSTRACT

Cutaneous polyarteritis nodosa is a rare form of cutaneous vasculitis that involves small and medium sized arteries of the dermis and subcutaneous tissue without systemic involvement. The diagnosis is based on clinical features of isolated skin involvement and confirmed by histopathological findings. The characteristic pathologic feature is a leukocytoclastic vasculitis in the small to medium sized arterioles of the deep dermis or hypodermis with or without associated fibrinoid necrosis. The clinical course is chronic with remissions, relapses, and a favorable prognosis. Mild cases may resolve with nonsteroidal anti-inflammatory drugs. However severe cases should be treated with systemic steroids.

We report a rare case of benign cutaneous PAN in a 50-yearold female who presented with history of fever, cutaneous ulcer, atrophic scar and subcutaneous nodule. The skin biopsy showed leukocytoclastic vasculitis with fibrinoid necrosis in the dermal vessels. Firstly she received treatment with colchicum, pentoxyphylline, dipiridamol, anti-inflammatory drugs that were ineffective. Then she received 40 mg/d systemic steroids and the lesions resolved with scar over a period of 3 months. This rare case was reported due to its dramatic response to moderate dose steroids.