Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.
Identifieur interne : 000651 ( Main/Exploration ); précédent : 000650; suivant : 000652Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.
Auteurs : Andrew Matsumoto [États-Unis] ; Rami N. Al-Rohil [États-Unis] ; Marina Bravin [États-Unis] ; Lori Anderson [États-Unis] ; Danielle Wroblewski [États-Unis] ; John A. Carlson [États-Unis]Source :
- Journal of cutaneous pathology [ 1600-0560 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Cellulite sous-cutanée (microbiologie), Femelle, Humains, Infections à streptocoques (), Lymphoedème (anatomopathologie), Lymphoedème (étiologie), Maladies auto-immunes (anatomopathologie), Maladies auto-immunes (étiologie), Peau (anatomopathologie), Polyartérite noueuse (anatomopathologie), Polyartérite noueuse (étiologie), Streptocoques viridans, Épaule ().
- MESH :
- anatomopathologie : Lymphoedème, Maladies auto-immunes, Peau, Polyartérite noueuse.
- microbiologie : Cellulite sous-cutanée.
- étiologie : Lymphoedème, Maladies auto-immunes, Polyartérite noueuse.
- Adulte d'âge moyen, Femelle, Humains, Infections à streptocoques, Streptocoques viridans, Épaule.
English descriptors
- KwdEn :
- Autoimmune Diseases (etiology), Autoimmune Diseases (pathology), Cellulitis (microbiology), Female, Humans, Lymphedema (etiology), Lymphedema (pathology), Middle Aged, Polyarteritis Nodosa (etiology), Polyarteritis Nodosa (pathology), Shoulder (surgery), Skin (pathology), Streptococcal Infections (complications), Viridans Streptococci.
- MESH :
- complications : Streptococcal Infections.
- etiology : Autoimmune Diseases, Lymphedema, Polyarteritis Nodosa.
- microbiology : Cellulitis.
- pathology : Autoimmune Diseases, Lymphedema, Polyarteritis Nodosa, Skin.
- surgery : Shoulder.
- Female, Humans, Middle Aged, Viridans Streptococci.
Abstract
Cutaneous polyarteritis nodosa (CPAN) is a chronic, indolent, single organ arteritis that generally presents with lower extremity nodules and/or livedo racemosa, accompanied by malaise and arthralgias. CPAN is often triggered by infection, commonly Group A streptococcal species, and is considered an autoimmune reaction. Scarring from surgery and obliterative lymphangiitis from bacterial cellulitis are the causes of lymphedema. Lymphedematous skin is predisposed to autoimmune disorders. Herein we report a 53-year-old woman who developed CPAN restricted to a localized area of the right upper arm-shoulder that had undergone multiple surgeries, complicated by episodes of Streptococcus viridans cellulitis. Clinically, a 15 cm diameter plaque exhibited violaceous, reticulate margins, subtle papules and nodules and central livedo racemosa. Biopsy showed numerous foci of arteritis in active, subacute and reparative stages. In addition, a broad zone of fibrosis replaced the deep dermis-subcutis zone and harbored numerous dilated lymphatic vessels scar lymphedema. Treatment consisted of high potency topical corticosteroids under occlusion; remission after 3 months therapy and follow-up. CPAN primarily affects the lower legs, a region of frequently affected by phlebolymphedema. This report of CPAN localized to an area of scar lymphedema underscores the importance of lymphatic function in the pathogenesis of CPAN.
DOI: 10.1111/cup.12861
PubMed: 27862152
Affiliations:
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CPAN is often triggered by infection, commonly Group A streptococcal species, and is considered an autoimmune reaction. Scarring from surgery and obliterative lymphangiitis from bacterial cellulitis are the causes of lymphedema. Lymphedematous skin is predisposed to autoimmune disorders. Herein we report a 53-year-old woman who developed CPAN restricted to a localized area of the right upper arm-shoulder that had undergone multiple surgeries, complicated by episodes of Streptococcus viridans cellulitis. Clinically, a 15 cm diameter plaque exhibited violaceous, reticulate margins, subtle papules and nodules and central livedo racemosa. Biopsy showed numerous foci of arteritis in active, subacute and reparative stages. In addition, a broad zone of fibrosis replaced the deep dermis-subcutis zone and harbored numerous dilated lymphatic vessels scar lymphedema. Treatment consisted of high potency topical corticosteroids under occlusion; remission after 3 months therapy and follow-up. CPAN primarily affects the lower legs, a region of frequently affected by phlebolymphedema. This report of CPAN localized to an area of scar lymphedema underscores the importance of lymphatic function in the pathogenesis of CPAN.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Matsumoto, Andrew" sort="Matsumoto, Andrew" uniqKey="Matsumoto A" first="Andrew" last="Matsumoto">Andrew Matsumoto</name></region><name sortKey="Al Rohil, Rami N" sort="Al Rohil, Rami N" uniqKey="Al Rohil R" first="Rami N" last="Al-Rohil">Rami N. Al-Rohil</name><name sortKey="Anderson, Lori" sort="Anderson, Lori" uniqKey="Anderson L" first="Lori" last="Anderson">Lori Anderson</name><name sortKey="Bravin, Marina" sort="Bravin, Marina" uniqKey="Bravin M" first="Marina" last="Bravin">Marina Bravin</name><name sortKey="Carlson, John A" sort="Carlson, John A" uniqKey="Carlson J" first="John A" last="Carlson">John A. Carlson</name><name sortKey="Wroblewski, Danielle" sort="Wroblewski, Danielle" uniqKey="Wroblewski D" first="Danielle" last="Wroblewski">Danielle Wroblewski</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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