Watanabe K, Nanki T, Sugihara T, Miyasaka N
Department of Medicine and Rheumatology, Graduate School,Tokyo Medical and Dental University, Tokyo, Japan.
Clin Exp Rheumatol. 2008 Nov-Dec;26(6):1113-5.
We describe a 54-year-old man presenting with cutaneous ulcerations, livedo reticularis, numbness of the legs, and skin histological findings compatible with the diagnosis of polyarteritis nodosa (PAN). Initial treatment with 50 mg/day of prednisolone (PSL) was effective. However, the symptoms and signs recurred, and the patient developed multiple periurethral aseptic abscesses, urethra-cutaneous fistula, and testicular lesions after tapering of PSL therapy. The condition improved with PSL and cyclophosphamide administration. Since penile and testicular vasculitis could be associated with PAN, although rarely, we should carefully distinguish such an involvement from infection and malignancy.