Cutaneous nodular polyarteritis presenting as refractory ulcers on both lower extremities: A case report

Area of Science:

• Dermatology
• Integrative Medicine
• Pharmacology

Background:

• Cutaneous polyarteritis nodosa (cPAN) is a skin-limited systemic vasculitis.
• cPAN manifests as reticular cyanotic, erythematous, and palpable nodules, often leading to cutaneous ulcers.
• Hormonal and immunosuppressive therapies can impede ulcer healing and increase recurrence risk.

Observation:

• A 48-year-old female with an 8-year history of recurrent lower limb erythema nodosum experienced worsening skin breakdown.
• Conventional treatments were ineffective, prompting a combined Traditional Chinese Medicine (TCM) and Western medicine approach.
• The patient underwent six months of combined therapy.

Findings:

• The combined TCM and Western medicine treatment led to the disappearance of new erythema and ulcers.
• Existing ulcers gradually reduced in size, and erythema resolved.
• Complete ulcer healing was achieved, with no recurrence observed three months post-treatment.

Implications:

• Combined TCM and low-dose hormone therapy presents a potentially effective strategy for treating cPAN-induced lower extremity ulcers.
• This integrated approach may offer a safer alternative, minimizing side effects associated with traditional treatments.
• Further research into this combined modality could advance cPAN management and improve patient outcomes.