Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, Japan.
J Am Acad Dermatol. 2010 Oct;63(4):602-6. doi: 10.1016/j.jaad.2009.10.033. Epub 2010 Aug 2.
Cutaneous polyarteritis nodosa (CPN) is an uncommon disorder that can be difficult to manage effectively. We have previously suggested that CPN might be associated with the presence of anti-phosphatidylserine-prothrombin complex (anti-PS/PT) antibodies, members of the antiphospholipid antibody family.
To evaluate clinical manifestations and effective treatments of CPN.
We conducted a retrospective analysis of three patients with CPN who responded to warfarin therapy. IgG and IgM anti-PS/PT antibodies were measured with a specific enzyme-linked immunosorbent assay.
There was a dramatic improvement in our three CPN patients following warfarin therapy adjusted to a target international normalized ratio (INR) of about 3.0. Active disease progression was halted by sustained warfarin therapy during which the patients experienced resolution of their skin manifestations.
A small number of cases were studied and the study design was retrospective.
We propose that warfarin therapy at a target INR of roughly 3.0 could be effective for treating patients with CPN. We further believe that treatment with warfarin led to the effective attenuation of anti-PS/PT antibodies related to prothrombin, and improved the symptoms in our CPN patients.
皮肤型多发性动脉炎（cutaneous polyarteritis nodosa，CPN）是一种不常见的疾病，治疗效果往往难以令人满意。我们曾提出 CPN 可能与抗磷脂酰丝氨酸-凝血酶原复合物（anti-phosphatidylserine-prothrombin complex，抗-PS/PT）抗体有关，后者是抗磷脂抗体家族的成员。
评估 CPN 的临床表现和有效治疗方法。
我们对 3 例对华法林治疗有反应的 CPN 患者进行了回顾性分析。采用特定的酶联免疫吸附试验检测 IgG 和 IgM 抗-PS/PT 抗体。
在将国际标准化比值（INR）调整至约 3.0 后，我们的 3 例 CPN 患者的病情明显改善。持续的华法林治疗阻止了疾病的进展，使患者的皮肤表现得到缓解。
研究的病例数量较少，且研究设计为回顾性。
我们建议将 INR 目标值设定在约 3.0 左右的华法林治疗可能对 CPN 患者有效。我们进一步认为，华法林治疗导致与凝血酶原相关的抗-PS/PT 抗体有效减弱，从而改善了我们 CPN 患者的症状。
