Acral Necrosis of the Fingers as Initial Manifestation of Cutaneous Polyarteritis Nodosa

Abstract

Cutaneous polyarteritis nodosa (CPN) is a well-known entity showing subcutaneous tender nodules, livedo reticularis, and ulcerations as predominant features; arthralgia, myalgia, periph eral neuropathy, and general symptoms such as fever and malaise may also be present. Although the localization of the disease is not specific, the characteristic primary lesions are painful subcutaneous nodules on the lower extremities. Here we report the case of a 33-year- old man with blue-colored distal phalanges and necrosis of several fingertips on both hands as the initial manifestation of CPN.