Cutaneous Polyarteritis Nodosa Presenting Atypically with Severe Pharyngeal Ulceration

Polyarteritis nodosa (PAN) is a multisystem, necrotising vasculitis of small- and medium-sized arteries with a predilection for the visceral vessels. Cutaneous PAN is a rare variant with symptomatic vasculitis limited to the skin, typically presenting as nodular lesions on the extremities with a propensity to ulcerate. We describe a rare case of histologically confirmed cutaneous PAN presenting in a 55-year-old Ghanaian woman with severe oropharyngeal ulceration. This was associated with dysphagia and significant weight loss. Oesophagoduodenoscopy showed that the ulceration extended throughout the oropharynx. Systemic polyarteritis nodosa was ruled out with magnetic resonance angiography. Our patient was treated successfully with corticosteroids and methotrexate. This case suggests that cutaneous PAN should be considered in the differential diagnosis of patients with oropharyngeal ulceration and that histological assessment is pivotal in establishing the diagnosis early in order to instigate appropriate therapy.

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Significance of Two Skin Biopsy Performances with Consecutive Deeper Sections in the Differential Diagnosis Between Cutaneous Polyarteritis Nodosa and Livedo Vasculopathy

Acta Dermato Venereologica ◽

10.2340/00015555-1603 ◽

2014 ◽

Vol 94 (1) ◽

pp. 84-85 ◽

Cited By ~ 6

Author(s):

T Kawakami ◽

S Kimura ◽

S Takeuchi ◽

Y Soma

Keyword(s):

Differential Diagnosis ◽

Skin Biopsy ◽

Polyarteritis Nodosa ◽

Cutaneous Polyarteritis Nodosa

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Cutaneous polyarteritis nodosa and tuberculosis in a child: a very rare case report

10.47660/cbr.2021.1994 ◽

2021 ◽

Author(s):

Reinan Tavares Campos ◽

Lucia Maria Mattei Arruda Campos ◽

Clovis Arthur A Silva ◽

Pedro Vale Bede ◽

Maria Fernanda Badue Pereira ◽

...

Keyword(s):

Case Report ◽

Polyarteritis Nodosa ◽

Rare Case ◽

Cutaneous Polyarteritis Nodosa ◽

Rare Case Report

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Cutaneous Rosai–Dorfman disease: a challenging diagnosis

BMJ Case Reports ◽

10.1136/bcr-2020-239244 ◽

2021 ◽

Vol 14 (2) ◽

pp. e239244

Author(s):

Rita Sampaio ◽

Leandro Silva ◽

Goreti Catorze ◽

Isabel Viana

Keyword(s):

Weight Loss ◽

Differential Diagnosis ◽

Physical Examination ◽

Plasma Cells ◽

Oral Prednisolone ◽

Inflammatory Cells ◽

Rosai Dorfman Disease ◽

History Of ◽

Nodular Lesions ◽

Proliferative Disease

Rosai–Dorfman disease is a rare benign histiocytic proliferative disease of unknown cause that, in exceptional cases, presents with lesions confined to the skin. Clinically variable types of lesions such as papules, nodules and plaques have been reported. We present a case of a 27-year-old woman with a 1-year history of erythematous papular and nodular lesions on the malar and right axillary regions, previously misdiagnosed as acne. She reported no fever, malaise or weight loss, while physical examination and laboratory workup were normal. Bacteriological and mycobacteriological cultures were negative. Histopathological findings showed dense infiltration of inflammatory cells involving the entire dermis, consisting of large macrophages with emperipolesis, S100 and CD68 positive, neutrophils, eosinophils, lymphocytes and plasma cells. The patient was treated with oral prednisolone without improvement. Dapsone was subsequently initiated with favourable clinical response. The present article aimed to emphasise the clinical and histological differential diagnosis and share the treatment experience.

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A RARE CASE OF ROSAI-DORFMAN DISEASE IN HYPOTHYROIDISM PATIENT A DIAGNOSTIC COEXISTENCE

10.36106/gjra/4300896 ◽

2021 ◽

pp. 31-32

Author(s):

Gridhati Srinivas ◽

Tarun Kumar Dutta

Keyword(s):

Weight Loss ◽

Differential Diagnosis ◽

Soft Tissue ◽

Rare Case ◽

Cervical Lymphadenopathy ◽

Nodal Involvement ◽

Nodal Disease ◽

Rosai Dorfman Disease ◽

Night Sweats ◽

Rule Out

Rosai-Dorfman disease (RDD) is a rare, benign, and predominantly nodal disease that most commonly presents as bilateral, painless cervical lymphadenopathy; although inguinal, axillary, mediastinal, and hilar lymphadenopathy has also been reported. Apart from nodal involvement, RDD has extra nodal manifestations involving bone, soft tissue, and liver as well as constitutional symptoms of fever, night sweats, and weight loss, which make it reasonable to rule out the infectious, autoimmune, and malignant conditions as the differential diagnosis.

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Ulcerative Colitis in a Bangladeshi Child: A Case Report

BIRDEM Medical Journal ◽

10.3329/birdem.v9i1.39733 ◽

2019 ◽

Vol 9 (1) ◽

pp. 89-94

Author(s):

Nazmul Hoque ◽

Shireen Ahmed ◽

Taslima Zaman

Keyword(s):

Ulcerative Colitis ◽

Weight Loss ◽

Differential Diagnosis ◽

Oral Steroid ◽

Inflammatory Disorder ◽

Bloody Stool ◽

Significant Weight Loss ◽

Meckel’S Diverticulitis ◽

Allergic Colitis

Introduction: Ulcerative colitis (UC) is a chronic idiopathic inflammatory disorder of colon. Ulcerative colitis is uncommon in tropics and sub-tropics. We describe a case of pediatric ulcerative colitis with successful treatment. A 4-years-old girl who presented with passage of loose bloody stool, abdominal pain and mild arthralgia along with significant weight loss. Her height was 95 cm, and weight was 13 kg. Diagnosis was confirmed by colonoscopy and histopathology. Treatment was thereafter started with parenteral steroid initially then oral steroid and mesalamine. The patient is now on remission and is on regular follow up. UC is rare in Bangladesh, especially in children. Several conditions like infective colitis, allergic colitis, Meckel’s diverticulitis, Crohn’s disease, etc. may mimic the features of UC. So, if a child presents with recurrent bloody diarrhea, UC should be considered as a differential diagnosis. Birdem Med J 2019; 9(1): 89-94

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Uncommon Association of Tuberculous Dactylitis and Cutaneous Polyarteritis Nodosa in a Hemodialysis Patient

Case Reports in Acute Medicine ◽

10.1159/000497426 ◽

2019 ◽

Vol 2 (1) ◽

pp. 8-12

Author(s):

Picha Yincharoen ◽

Nattachai Srisawat

Keyword(s):

Polyarteritis Nodosa ◽

End Stage Renal Disease ◽

Hemodialysis Patient ◽

Extrapulmonary Tuberculosis ◽

Cutaneous Polyarteritis Nodosa ◽

Rare Association ◽

Nodular Lesions ◽

Pediatric Populations ◽

Stage Renal Disease ◽

End Stage

Tuberculous dactylitis, defined as the infection of the metacarpals, metatarsals, or phalanges of the hands or feet, is an uncommon manifestation of extrapulmonary tuberculosis. It is mainly seen in pediatric populations, especially those less than 6 years old. Here, we present a case of tuberculous dactylitis in an elderly patient with end-stage renal disease on hemodialysis. Moreover, our patient also developed generalized nodular lesions during hospitalization. Skin biopsy was consistent with cutaneous polyarteritis nodosa, which is a rare association with tuberculosis. She was treated with antituberculous drugs with significant improvement in both cutaneous nodules and dactylitic lesions.

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Cutaneous Polyarteritis Nodosa: Uncommon and Rare Form of Cutaneous Vasculitis

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2018-0008 ◽

2018 ◽

Vol 10 (2) ◽

pp. 47-51

Author(s):

Branislav Lekić ◽

Danijela Milčić ◽

Mirjana Popadić ◽

Dušan Škiljević ◽

Mirjana Milinković Srećković

Keyword(s):

Polyarteritis Nodosa ◽

Histopathological Examination ◽

Oral Prednisone ◽

Lower Limbs ◽

Cutaneous Polyarteritis Nodosa ◽

Short Course ◽

Nodular Lesions ◽

One Year ◽

The One ◽

Nodular Vasculitis

Abstract Cutaneous polyarteritis nodosa (CPAN) is a variant of polyarteritis nodosa that is limited primarily to the skin. It is a chronic recurrent disorder characterized by the presence of nodular lesions with or without ulceration on the distal third of the lower limbs. Nodular vasculitis and thrombophlebitis can be clinically or pathologically mistaken for CPAN. We present a case of a 51-year-old woman with painful nodules on the lower limbs. Some of the nodules were ulcerated. Histopathological examination of a nodule on deep incisional biopsy revealed fibrinoid necrosis of a medium-sized artery in the subcutis along with perivascular mixed infiltrate. The patient did not have any symptoms or signs of internal organ involvement. The possible etiological factor has not been detected. The patient was treated with oral prednisone 0.5 mg/kg/day and dapson 150 mg/day. Over the one-year follow-up the lesions showed regression, with one minimal relapse which resolved after the short course of oral prednisone.

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