Magnant J, Lhommet C, Machet L, Machet M-C, Guilmot J-L, Diot E
Service de médecine interne B, hôpital Bretonneau, université François-Rabelais, CHRU de Tours, 2 bis, boulevard Tonnellé, 37044 Tours, France.
Rev Med Interne. 2009 Apr;30(4):345-8. doi: 10.1016/j.revmed.2008.10.335. Epub 2008 Dec 13.
Cutaneous polyarteritis nodosa (CPAN) is an entity which needs to be acknowledged, since it can have a spontaneously adverse outcome. We report two cases of CPAN associated with Crohn's disease.
The first patient was suffering from Crohn's disease for 9 years when she was referred for a necrotic toe. A diagnosis of necrotizing angeitis was confirmed by histological examination of a skin biopsy. Despite systemic corticosteroids, the lesions became more severe, requiring immunosuppressive treatment. The second patient was a female patient referred with forefoot ischemia. Cutaneous histology confirmed the diagnosis of necrotizing angeitis that responded favourably to corticosteroid treatment. The patient had been diagnosed with Crohn's disease 2 months previously.
CPAN differed from systemic PAN by the absence of visceral involvement. Its association with Crohn's disease, although uncommon, must be recognized as it affects treatment and monitoring.
皮肤型结节性多动脉炎（CPAN）是一种需要被认识的疾病，因为它可能会有自发的不良后果。我们报告两例与克罗恩病相关的CPAN病例。
首例患者患克罗恩病9年后因趾部坏死前来就诊。皮肤活检的组织学检查确诊为坏死性血管炎。尽管使用了全身性皮质类固醇，但病变仍加重，需要免疫抑制治疗。第二例患者是一名因前足缺血前来就诊的女性患者。皮肤组织学检查确诊为坏死性血管炎，对皮质类固醇治疗反应良好。该患者在就诊前2个月被诊断为克罗恩病。
CPAN与系统性多动脉炎（PAN）的不同之处在于无内脏受累。其与克罗恩病的关联虽不常见，但因其影响治疗和监测，必须予以认识。
