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Therapeutic options for cutaneous polyarteritis nodosa: a systematic review
Eleni Papachristodoulou1, Loukas Kakoullis1, Eleni Tiniakou2
1Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus.
Rheumatology (Oxford, England)
|May 4, 2021
Summary
This systematic review found limited evidence for cutaneous polyarteritis nodosa (CPAN) treatments, with systemic corticosteroids commonly used for induction. Further research is needed to assess treatment effects on CPAN remission and relapses.
Area of Science:
- Rheumatology
- Dermatology
- Internal Medicine
Background:
- Cutaneous polyarteritis nodosa (CPAN) is a rare necrotizing vasculitis affecting medium-sized vessels primarily in the skin.
- Effective treatment strategies for CPAN remain incompletely defined due to limited research.
Purpose of the Study:
- To systematically review existing literature on treatment modalities for cutaneous polyarteritis nodosa (CPAN) in adults.
- To identify and evaluate the efficacy of various therapeutic approaches for CPAN management.
Main Methods:
- A systematic review adhering to PRISMA guidelines was conducted.
- Searches of PubMed/Medline databases were performed up to December 2020 for studies on CPAN therapy, management, or treatment.
- Seven case series involving 325 adult patients with CPAN were included.
Main Results:
- Systemic corticosteroids were frequently employed as initial treatment for CPAN.
- A range of immunosuppressive agents, including azathioprine, cyclophosphamide, and rituximab, were used in combination with corticosteroids.
- Other treatments such as dapsone, colchicine, and antiplatelet agents were also utilized; skin ulcerations correlated with higher relapse risk.
Conclusions:
- The current evidence base for managing CPAN is limited.
- Further research is essential to determine the impact of different treatments on disease remission, relapse rates, and patient mortality in CPAN.
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