[Cutaneous polyarteritis nodosa and Crohn's disease: An association not to be ignored]
J Magnant1, C Lhommet, L Machet
1Service de médecine interne B, hôpital Bretonneau, université François-Rabelais, CHRU de Tours, 2 bis, boulevard Tonnellé, 37044 Tours, France.
Introduction:
Cutaneous polyarteritis nodosa (CPAN) is an entity which needs to be acknowledged, since it can have a spontaneously adverse outcome. We report two cases of CPAN associated with Crohn's disease.
Case Reports:
The first patient was suffering from Crohn's disease for 9 years when she was referred for a necrotic toe. A diagnosis of necrotizing angeitis was confirmed by histological examination of a skin biopsy. Despite systemic corticosteroids, the lesions became more severe, requiring immunosuppressive treatment. The second patient was a female patient referred with forefoot ischemia. Cutaneous histology confirmed the diagnosis of necrotizing angeitis that responded favourably to corticosteroid treatment. The patient had been diagnosed with Crohn's disease 2 months previously.
Conclusion:
CPAN differed from systemic PAN by the absence of visceral involvement. Its association with Crohn's disease, although uncommon, must be recognized as it affects treatment and monitoring.
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