Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.
Identifieur interne : 000511 ( PubMed/Corpus ); précédent : 000510; suivant : 000512Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.
Auteurs : Andrew Matsumoto ; Rami N. Al-Rohil ; Marina Bravin ; Lori Anderson ; Danielle Wroblewski ; John A. CarlsonSource :
- Journal of cutaneous pathology [ 1600-0560 ] ; 2017.
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
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pubmed:27862152Le document en format XML
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Al-Rohil</name><affiliation><nlm:affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Bravin, Marina" sort="Bravin, Marina" uniqKey="Bravin M" first="Marina" last="Bravin">Marina Bravin</name><affiliation><nlm:affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Anderson, Lori" sort="Anderson, Lori" uniqKey="Anderson L" first="Lori" last="Anderson">Lori Anderson</name><affiliation><nlm:affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wroblewski, Danielle" sort="Wroblewski, Danielle" uniqKey="Wroblewski D" first="Danielle" last="Wroblewski">Danielle Wroblewski</name><affiliation><nlm:affiliation>Wadsworth Center, New York State Department Health, Albany, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Carlson, John A" sort="Carlson, John A" uniqKey="Carlson J" first="John A" last="Carlson">John A. Carlson</name><affiliation><nlm:affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:27862152</idno><idno type="pmid">27862152</idno><idno type="doi">10.1111/cup.12861</idno><idno type="wicri:Area/PubMed/Corpus">000511</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000511</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.</title><author><name sortKey="Matsumoto, Andrew" sort="Matsumoto, Andrew" uniqKey="Matsumoto A" first="Andrew" last="Matsumoto">Andrew Matsumoto</name><affiliation><nlm:affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</nlm:affiliation></affiliation></author><author><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><affiliation><nlm:affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Bravin, Marina" sort="Bravin, Marina" uniqKey="Bravin M" first="Marina" last="Bravin">Marina Bravin</name><affiliation><nlm:affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Anderson, Lori" sort="Anderson, Lori" uniqKey="Anderson L" first="Lori" last="Anderson">Lori Anderson</name><affiliation><nlm:affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Wroblewski, Danielle" sort="Wroblewski, Danielle" uniqKey="Wroblewski D" first="Danielle" last="Wroblewski">Danielle Wroblewski</name><affiliation><nlm:affiliation>Wadsworth Center, New York State Department Health, Albany, NY, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Carlson, John A" sort="Carlson, John A" uniqKey="Carlson J" first="John A" last="Carlson">John A. Carlson</name><affiliation><nlm:affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of cutaneous pathology</title><idno type="eISSN">1600-0560</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Autoimmune Diseases (etiology)</term><term>Autoimmune Diseases (pathology)</term><term>Cellulitis (microbiology)</term><term>Female</term><term>Humans</term><term>Lymphedema (etiology)</term><term>Lymphedema (pathology)</term><term>Middle Aged</term><term>Polyarteritis Nodosa (etiology)</term><term>Polyarteritis Nodosa (pathology)</term><term>Shoulder (surgery)</term><term>Skin (pathology)</term><term>Streptococcal Infections (complications)</term><term>Viridans Streptococci</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Streptococcal Infections</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Autoimmune Diseases</term><term>Lymphedema</term><term>Polyarteritis Nodosa</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Cellulitis</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Autoimmune Diseases</term><term>Lymphedema</term><term>Polyarteritis Nodosa</term><term>Skin</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Shoulder</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Viridans Streptococci</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27862152</PMID><DateCreated><Year>2016</Year><Month>11</Month><Day>18</Day></DateCreated><DateCompleted><Year>2017</Year><Month>08</Month><Day>15</Day></DateCompleted><DateRevised><Year>2017</Year><Month>08</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1600-0560</ISSN><JournalIssue CitedMedium="Internet"><Volume>44</Volume><Issue>2</Issue><PubDate><Year>2017</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Journal of cutaneous pathology</Title><ISOAbbreviation>J. Cutan. Pathol.</ISOAbbreviation></Journal><ArticleTitle>Cutaneous polyarteritis nodosa localized to a region of lymphedema secondary to Streptococcus viridans cellulitis and multiple surgeries.</ArticleTitle><Pagination><MedlinePgn>210-216</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/cup.12861</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Matsumoto</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Al-Rohil</LastName><ForeName>Rami N</ForeName><Initials>RN</Initials><AffiliationInfo><Affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bravin</LastName><ForeName>Marina</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anderson</LastName><ForeName>Lori</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Pathology, Bassett Healthcare Network, Cooperstown, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wroblewski</LastName><ForeName>Danielle</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Wadsworth Center, New York State Department Health, Albany, NY, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carlson</LastName><ForeName>John A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Department of Pathology, Albany Medical College, Albany, NY, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>12</Month><Day>12</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Cutan Pathol</MedlineTA><NlmUniqueID>0425124</NlmUniqueID><ISSNLinking>0303-6987</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D001327" MajorTopicYN="N">Autoimmune Diseases</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002481" MajorTopicYN="N">Cellulitis</DescriptorName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010488" MajorTopicYN="N">Polyarteritis Nodosa</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012782" MajorTopicYN="N">Shoulder</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012867" MajorTopicYN="N">Skin</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013290" MajorTopicYN="N">Streptococcal Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D034363" MajorTopicYN="N">Viridans Streptococci</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Streptococcus viridans</Keyword><Keyword MajorTopicYN="N">cellulitis</Keyword><Keyword MajorTopicYN="N">cutaneous polyarteritis nodosa</Keyword><Keyword MajorTopicYN="N">localized lymphedema</Keyword><Keyword MajorTopicYN="N">vasculitis</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>07</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>11</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>11</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>11</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>8</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>11</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27862152</ArticleId><ArticleId IdType="doi">10.1111/cup.12861</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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