2017 Volume 29 Issue 2 Pages 121-127
Cutaneous arteritis (CA) is a vasculitis involving small and medium-sized arteries localized at the dermal-pannicular junction; its pathogenesis is unknown. A 24-year-old woman was admitted to our hospital because of burning pain in her hands and feet and digital ischemia, Raynaud phenomenon, and livedo reticularis. Blood test results revealed elevated erythrocyte sedimentation rate and were negative for autoantibodies. Angiography of her left hand revealed a filling delay in the distal portion of the ulnar artery and palmar arch. Biopsy of plantar skin revealed leukocytoclastic vasculitis with fibrinoid necrosis at the dermal-pannicular junction. We made a diagnosis of CA. Treatment with multiple vasodilators and an antithrombotic worsened her skin lesion. Therefore, she was treated with 40 mg/day prednisolone. After initiating corticosteroid treatment, her skin lesion rapidly improved; she was discharged after 37 days. Typical clinical manifestations of CA include tender subcutaneous nodules, livedo reticularis, and cutaneous ulcerations on the lower extremities. Fever, arthralgia, myalgia, and peripheral neuropathy may also manifest. Although distal ischemia and Raynaud phenomenon are rare, CA should be considered as a differential diagnosis of these symptoms.
