Viêm đa động mạch nút ở da: Báo cáo ca lâm sàng hiếm gặp

Abstract

Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis that predominantly involves medium-sized muscular arteries. Cutaneous polyarteritis nodosa (cPAN), also referred to as TA, represents a skin-limited variant characterized by vasculitis of medium-sized dermal arteries without the severe visceral complications seen in systemic PAN. Diagnosis is generally based on a combination of clinical features and supportive laboratory findings. The 1990 American College of Rheumatology (ACR) classification criteria-requiring the presence of three or more out of ten items-provide a sensitivity of approximately 82% and a specificity of 86%; however, definitive diagnosis ideally relies on histopathological confirmation or angiographic evidence of vascular involvement. We describe the case of a 21-year-old man who presented to Hanoi Medical University Hospital with fever and slowly healing necrotic ulcerative skin lesions. Histopathological examination of a skin biopsy demonstrated necrotizing vasculitis involving small- to medium-sized arteries, confirming the diagnosis of cPAN. The patient was treated with systemic corticosteroids, colchicine, and hydroxychloroquine, with marked improvement in cutaneous lesions after two months of therapy.