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.
KeywordsSural Nerve Hairy Cell Leukemia Polyarteritis Nodosa Visceral Involvement Angiographic Appearance
- 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.CrossRefGoogle Scholar