Cutaneous Polyarteritis Nodosa in Childhood: A Case Report

Abstract

Introduction: Cutaneous polyarteritis nodosa (cPAN) is a rare form of pediatric vasculitis affecting small-to-medium-sized arteries at the dermo-subcutaneous junction and panniculus. It is essential to be aware of cPAN early to prevent misdiagnosis and guide the appropriate treatment. Case Presentation: A 5-year-old girl presented with relapsing rashes on the dorsum of the hands and feet, along with palpable, mobile, and non-indurated cervical lymphadenopathy on both sides of the neck. Skin biopsy revealed fibrinoid necrosis, orthokeratosis in the epidermis, a well-structured epithelium, perivascular sparse lymphocytes in the upper dermis, and neutrophil-rich inflammatory infiltrates in the medium-sized vessel walls of the subcutaneous fat tissue. The presence of medium-sized vasculitis in the skin biopsy confirmed cPAN. Conclusions: This case highlights the importance of cPAN in pediatric patients with cutaneous lesions. Although it is rare in childhood, given its chronic and recurrent nature, long-term follow-up is essential to monitor disease progression, assess treatment response, and prevent complications.