Pelletier Fabien, Puzenat Eve, Blanc Dominique, Faivre Brigitte, Humbert Philippe, Aubin François
Department of Dermatology, University Hospital, 2 Place Saint-Jacques, 25030 Besançon, France.
Eur J Dermatol. 2003 Jul-Aug;13(4):396-8.
Minocycline is an antibiotic widely used in the treatment of acne. Among the induced auto-immune disorders, cutaneous polyarteritis nodosa (PAN) is very rare. A new case is reported below. A 23-year-old female patient treated with minocycline for acne for 24 months developed sub-cutaneous nodules, livedo reticularis and pigmented lesions of the lower limbs. Antineutrophil cytoplasmic antibodies (ANCA) were positive at 1/320. Skin biopsy showed vasculitis of a medium-sized artery. The role of minocycline was suspected using the imputability criteria. The diagnosis of minocycline-induced cutaneous PAN with ANCA was sustained. After withdrawal of the treatment, the nodular lesions decreased spontaneously, whereas livedo disappeared and inflammatory parameters were normalized after oral corticosteroid therapy. Minocycline is a tetracycline which is efficient for treating acne. Auto-immune disorders are frequently observed. Among them, it is very rare to observe cutaneous PAN associated with positive ANCA. The pathophysiological mechanisms are discussed.
米诺环素是一种广泛用于治疗痤疮的抗生素。在其诱发的自身免疫性疾病中，皮肤型结节性多动脉炎（PAN）非常罕见。以下报告一例新病例。一名23岁女性患者因痤疮接受米诺环素治疗24个月后，出现皮下结节、网状青斑和下肢色素沉着病变。抗中性粒细胞胞浆抗体（ANCA）为1/320阳性。皮肤活检显示中等大小动脉的血管炎。根据可归因性标准怀疑米诺环素的作用。米诺环素诱发的伴ANCA阳性的皮肤型PAN诊断成立。停药后，结节性病变自发减少，而网状青斑消失，口服糖皮质激素治疗后炎症指标恢复正常。米诺环素是一种对治疗痤疮有效的四环素。自身免疫性疾病经常可见。其中，伴ANCA阳性的皮肤型PAN非常罕见。本文对其病理生理机制进行了讨论。
