Benign cutaneous polyarteritis nodosa. Relationship to systemic polyarteritis nodosa and to hepatitis B infection

Benign cutaneous polyarteritis nodosa has been described as having a benign course in contrast to that of systemic classic polyarteritis nodosa. We tested the hypothesis that this histologic distinction is false by reviewing nine consecutive cases with the histologic diagnosis of benign cutaneous polyarteritis nodosa. Our study revealed that on follow-up, seven (78%) of nine cases had evidence of involvement of at least one organ other than the skin, with the kidney being the organ most commonly involved. Four (44%) of nine patients had serologic evidence of hepatitis B infection, one had cryoglobulinemia, and one had polyclonal hypergammaglobulinemia associated with acquired immunodeficiency syndrome. We conclude that benign cutaneous polyarteritis nodosa is not necessarily benign and is closely related to systemic polyarteritis nodosa.