Relationship between cutaneous polyarteritis nodosa (cPAN) and macular lymphocytic arteritis (MLA): Blinded histologic assessment of 35 cPAN cases

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• 作者：Amandine Buffiere-Morgado ; MD ; Maxime Battistella ; MD ; PhD ; Marie-Dominique Vignon-Pennamen ; MD ; Adè ; le de Masson ; MD ; Michel Rybojad ; MD ; Antoine Petit ; MD ; Florence Cordoliani ; MD ; Edouard Begon ; MD ; Bé ; atrice Flageul ; MD ; Alfred Mahr ; MD ; PhD ; Martine Bagot ; MD ; PhD ; Jean-David Bouaziz ; MD ; PhD ; ^{jean-david.bouaziz@aphp.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：cutaneous periarteritis nodosa ; lymphocytic thrombophilic arteritis ; macular arteritis ; macular lymphocytic arteritis ; periarteritis nodosa ; vasculitis
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：73
• 期：6
• 页码：1013-1020
• 全文大小：1791 K

文摘

Cutaneous polyarteritis nodosa (cPAN) is a skin medium vessel neutrophilic arteritis with livedo, nodules, and ulcerations. Macular lymphocytic arteritis (MLA) is a small arteritis with erythematous or pigmented macules and typical histologic features (a lymphocytic infiltrate, concentric fibrin ring, no disruption of the internal elastic lamina).

Objective

We sought to assess the frequency of clinical and histologic features of MLA in patients with cPAN.

Methods

This was a monocentric retrospective analysis of patients given the diagnosis of cPAN with blinded assessment of skin biopsy specimens.

Results

All 35 patients included had an infiltrated livedo, nodules, or both. Ulceration was rare. Erythematous or pigmented lesions were present in 54% of patients. Predominantly lymphocytic arteritis, a paucity of neutrophils, concentric fibrin ring, and absence of internal lamina elastic disruption were present in 60%, 20%, 18%, and 23% of patients, respectively. Median follow-up was 11 years. None of the patients had systemic involvement, and 57% had a complete remission. The incidence of complete remission was not different between patients having a predominant lymphocyte infiltrate or few neutrophils.

Limitations

This was a retrospective, monocentric study without a control group of patients with MLA.

Conclusions

Our data do not favor the classification of cPAN and MLA as distinct entities.