Cutaneous Polyarteritis Nodosa Presenting With Digital Gangrene And Breast Ulcer

    October 2013 in “ International Journal of Rheumatic Diseases ”
    Pooja Dhaon, Nagma Bansal, Siddharth Kumar Das, Anupam Wakhlu, Vini Tandon
    TLDR A young woman with severe symptoms of CPAN improved with intensive treatment but needed a leg amputation.
    A 23-year-old woman presented with severe ischemic loss of both lower limbs and a breast ulcer, which were unusual initial manifestations of cutaneous polyarteritis nodosa (CPAN). Despite normal CRP and negative immunological tests for systemic vasculitis, a biopsy confirmed CPAN through histopathological findings. The patient was treated with high-dose steroids and cyclophosphamide, leading to the healing of the breast ulcer and regression of gangrene, although she required below-knee amputation. This case highlighted the need for intensive treatment in severe CPAN presentations, which are typically benign but can manifest aggressively.
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