Volume 68 Numbers 4 & 5 September / October 2001	back to contents

Cutaneous Polyarteritis Nodosa after Streptococcal Necrotizing Fasciitis	336–338
Ronnit Hamuy Stein, M.D., Robert G. Phelps, M.D., and Allen N. Sapadin, M.D.
Address correspondence to Allen N. Sapadin, M.D., The Mount Sinai Medical Center, Box 1047, One East 100th Street, New York, NY 10029-6574.

ABSTRACT
Polyarteritis nodosa (PAN) is a necrotizing arteritis of small and medium-sized vessels. It may present with hypertension and/or renal insufficiency. Peripheral neuropathy, myopathy, joint pains, testicular pain, and ischemic myalgias may also be seen. Gastrointestinal involvement may lead to gangrene of the bowel, peritonitis, perforation, intra-abdominal hemorrhage, and pancreatitis. The cutaneous manifestations include tender subcutaneous nodules grouped along the course of superficial arteries of the lower extremities, with or without an overlying livedo reticularis. Although multisystem involvement is characteristic, sometimes only one organ or system may be involved. Associations with viral hepatitis (both B and C) and streptococcal infection have been established for PAN. Recurrent strep infections of the upper respiratory tract, streptococcal glomerulonephritis and rheumatic fever have previously been linked to PAN. This report extends the spectrum of associated streptococcal infections to include necrotizing fasciitis.

KEY WORDS
Polyarteritis nodosa, necrotizing fasciitis

MSSM Home

Back Issues | Indexes | Search | Journal Home