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Polyarteritis Nodosa

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Skin Manifestations in Rheumatic Disease
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Abstract

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. Small muscular arteries can occasionally be affected. PAN may affect any organ except lungs. Skin lesions are present in about 50 % of patients. Livedo reticularis, eruptions, skin infarctions, ulcerations, subcutaneous erythematous nodules, and digital ischemic changes may occur. The association of PAN with HBV is particularly strong. Diagnosis requires the integration of clinical, angiography, and biopsy findings. A cutaneous form of polyarteritis, affecting predominantly the lower extremities, is distinguished from systemic PAN by its restriction to the skin and to the neurological and osteo-muscular systems, lack of visceral involvement, and benign course. The skin involvement in microscopic polyangiitis (MPA) may mimic PAN. Biopsy of an affected artery can confirm the diagnosis. The specimen for biopsy may include the skin, skeletal muscle, sural nerve, liver, and kidney, depending on the clinical features.

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References

  1. Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides: proposal of an international consensus conference. Arthritis Rheum. 1994;37:187–92.

    Article  PubMed  CAS  Google Scholar 

  2. Guillevin L. Polyarteritis nodosa and microscopic polyangiitis. In: Ball GV, Bridges SL, editors. Vasculitis. New York: Oxford University Press; 2002. p. 300–20.

    Google Scholar 

  3. Pagnoux C, Mahr A, Cohen P, Guillevin L. Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome or rheumatoid arthritis- associated vasculitis. Medicine (Baltimore). 2005;84:115–28.

    Article  Google Scholar 

  4. Guillevin L, Mahr A, Callard P, et al. Hepatitis B virus-associated polyarteritis nodosa. Medicine (Baltimore). 2005;84:313–22.

    Article  Google Scholar 

  5. Watts R, Lane S, Hanslick T, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis. 2006;66:222–7.

    Article  PubMed  Google Scholar 

  6. Lightfoot RW, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum. 1990;33:1088–94.

    Article  PubMed  Google Scholar 

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Correspondence to Mehmet Tuncay Duruöz M.D. .

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Duruöz, M.T. (2014). Polyarteritis Nodosa. In: Matucci-Cerinic, M., Furst, D., Fiorentino, D. (eds) Skin Manifestations in Rheumatic Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7849-2_37

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  • DOI: https://doi.org/10.1007/978-1-4614-7849-2_37

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