Cutaneous Polyarteritis Nodosa Treated with Pentoxifylline and Clobetasol Propionate: A Case Report

Abstract

Cutaneous polyarteritis nodosa is a rare type of cutaneous vasculitis. It affects the small- and medium-sized arteries of the dermis and subcutaneous tissue without extracutaneous involvement. The diagnosis is by skin biopsy, and the characteristic finding is a leukocytoclastic vasculitis. We report a case of a 14-year-old Saudi girl who was referred to the dermatology service because of multiple ulceronecrotic lesions on the frontal aspects of the distal lower limbs. She had past medical consultations and treatment but without improvement. The histopathology confirmed the clinical diagnosis of cPAN, and ultimately, she responded to treatment with pentoxifylline and topical clobetasol propionate. It is important to be aware of this disease and refer the patient to the dermatology service for the appropriate evaluation and treatment.

Keywords: Cutaneous polyarteritis nodosa; Saudi Arabia; pentoxifylline; polyarteritis nodosa; topical steroids.

Figure 1

Multiple ulcerated lesions on the left ankle

Figure 2

Multiple necrotic lesions on the right ankle

Figure 3

Necrosis of the upper half of epidermis (hematoxylin and eosin stain)

Figure 4

Closer view of the vessel showing fibrinoid necrosis and a predominantly mononuclear perivascular and mural inflammatory infiltrates (hematoxylin and eosin stain)

Figure 5

Healed left ankle lesions

Figure 6

Healed right ankle lesion