[Cutaneous panarteritis nodosa with destructive arthritis]

The existence of arthritis in cutaneous panarteritis nodosa (CPAN) is controversial. We report a 52-year-old male with chronic destructive arthritis of both knees and palpable purpura in the feet, where the underlying histological finding was necrotizing arteritis. Systemic involvement was not demonstrated. AntiHBc and antiHBs antibodies were positive. Four of the 11 cases of CPAN with arthritis that we have found reported in the literature were well documented, and only one developed erosions of the joints. Our patient is the first reported case of CPAN with destructive arthritis and evidence of previous hepatitis B virus infection.