CUTANEOUS POLYARTERITIS NODOSA WITH EARLY DIGITAL GANGRENE, SALVAGED WITHOUT AMPUTATION A CASE REPORT

Cutaneous polyarteritis nodosa (CPAN) is an uncommon form of vasculitis involving small and medium sized arteries of unknown aetiology. The disease can be differentiated from polyarteritis nodosa by its limitation to the skin and lack of progression to visceral involvement. The characteristic manifestations are subcutaneous nodule, livedo reticularis, and ulceration, mostly localized on the lower extremities. We present a case of 6 years old girl presented with subcutaneous nodules, livedo reticularis, and early gangrenous changes of both index fingers, without systemic manifestations. Occurrence of gangrene is an unusual initial manifestation of CPAN. Salvage of gangrenous finger without amputation is very rare.Therapy with Methyl prednisolone, Nicoumalone, Methotrexate produced a marked improvement, patient discharged and on regular follow up.