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Ingrid Boehm, MD; Ralf Bauer, MD
University of Bonn, Bonn, Germany

Arch Dermatol. 2000;136:167-169.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 41-year-old white man presented with a 7-year history of erythematous papules, livedo reticularis, swelling, myalgias, arthralgias, Raynaud phenomenon, and very large, painful and progressive ulcers on the lower part of both legs (Figure 1). A skin biopsy specimen revealed polyarteritis nodosa (PAN) with fibrinoid necrosis of medium-sized vessels. The patient fulfilled 4 of the criteria for PAN (ie, weight loss >4 kg, livedo reticularis, myalgias, and characteristic histological picture).¹ Also, he had an elevated erythrocyte sedimentation rate, leukocyte count (Figure 2), CD3⁺ cell count (pan-T cells) (3.5 x 10⁹/L), CD3⁺CD4⁺ T-cell count (T-helper cells) (2.7 x 10⁹/L), and antinuclear antibody titer (1:640, speckled pattern). Systemic prednisone therapy administered at dosages as high as 100 mg/d had little, if any, effect. The patient's intense pain could only be controlled with morphine derivatives.

Figure appears in full text version. Figure 1. Polyarteritis nodosa with . . . [Full Text of this Article]

THERAPEUTIC CHALLENGE

SOLUTION

COMMENT