Abstract
We describe a case of cutaneous polyarteritis nodosa with mutiple indurated erythema in a 55-year-old Japanese woman. She was referred to our hospital with fever up to 38°C, chill, systemic malaise and multiple indurated erythema on the trunk and limbs.
Biopsy of an erythema on the lower leg was performed. Histopathological examination showed infiltration of neutrophils, lymphocytes and histiocytes around the small arteries in the lower dermis and in the lobules of fat cells. We could also find fibrinoid degeneration and leukocytoclastic vasculitis of small arteries. Elastica-van Gieson staining revealed small arteries characterized by destruction of the internal elastic laminae and disappearance of external elastic laminae. Laboratory data revealed absence of MPO-ANCA and PR3-ANCA and positive occult blood in stool. Histopathologically we could not find vasculitis in the intestinal mucous membranes.
We made a diagnosis of cutaneous polyarteritis nodosa, according to histopathological examination and clinical findings.
We cannot, however, rule out that the present case may develop systemic PN. Close follow up is necessary.
We also discussed the relationship between necrotizing vasculitis and EBV infection.
