Cutaneous polyarteritis nodosa in patients presenting with atrophie blanche

Abstract

In patients presenting with atrophie blanche without evidence of venous insufficiency and thrombophilia, PAN should be excluded, particularly in the presence of mononeuritis multiplex. Repeated and deep biopsies are often necessary to reveal the accurate underlying pathology of necrotizing medium-sized vasculitis in the reticular dermis and the subcutis, especially in the setting of atrophie blanche lesions. Immunosuppressive therapy was effective in controlling the PAN-associated clinical manifestations.

Livedoid vasculopathy associated with peripheral neuropathy: a report of two cases

“…2,4,6 The nerve conduction studies show decreased amplitudes of the motor and sensory nerve action potentials with slight reduction of nerve conduction velocities 7 , pointing to an axonal neuropathy of asymmetrical distribution consistent with mononeuritis multiplex. 8 …”

Livedoid Vasculopathy

“…6,14 The term atrophie blanche was once synonymous with this disease; however, clinical classification is often difficult because lesions resembling atrophie blanche have been described in diseases other than livedoid vasculopathy. 15,16 The minority of patients in this series who did not have classic atrophie blanche changes were described as having either multiple stellate shallow ulcers or crusted erosions.…”

Livedoid vasculopathy associated with combined prothrombin G20210A and factor V (Leiden) heterozygosity and MTHFR C677T homozygosity

“…LV is clinically characterized by painful cutaneous ulcerations of the lower extremities [4], with the earliest lesions consisting of painful purpuric macules. Subsequent ulceration lesions are followed by gradual healing, leaving telangiectasias-surrounded scars with skin atrophy [5]. LV is associated with dermal blood vessels thickening, endothelial proliferation, and focal thrombosis with no evidence of leukocytoclastic vasculitis [6].…”