- Indian Rheumatology association
A 33-year-old male presented with reddish raised painful rashes in both lower limbs, more below the knees over the past 3 days. Patient had associated high grade fever with chills. On examination patient had many erythematous tender nodules, few of themshowing central necrosis. On investigations, patient had neutrophilic leukocytosis, thrombocytosis with raised CRP and serum LDH. Skin biopsy histopathological examination showed adipose tissue along with small arterioles. Arterioles showed fibrinoid necrosis of the wall with thrombosis along with dense infiltration in the wall and in surrounding tissue by neutrophils and eosinophils.
Cutaneous Polyarteritis Nodosa
Cutaneous polyarteritis nodosa is a form of vasculitis that primarily affects the skin. It causes painful erythematous nodules, ulcers or livedo reticularis often on the lower legs. It is caused due to inflammation of medium sized blood vessels in the skin resulting in ischemia and necrosis. It may be triggered by infections, autoimmune diseases or drugs. Treatment involves steroids and immunosuppression.
