Non-Neoplastic Dermatopathology

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5.12 Nodular Vasculitis vs Polyarteritis Nodosa

Nodular Vasculitis

Polyarteritis Nodosa

Treatment

Identification and treatment of underlying cause, including therapy for active or latent tuberculosis if present. Nonsteroidal anti-inflammatory medications and rest for symptomatic relief. Oral potassium iodide provides rapid response in most cases. Variable course. Resolution of disease with treatment of underlying cause, but cases associated with tuberculosis may recur. Idiopathic cases may persist for months to years.

Mild cases may be treated with nonsteroidal anti-inflammatory drugs, topical corticosteroids, or colchicine. More severe disease may require systemic corticosteroids with or followed by colchicine, dapsone, Typically has a chronic, relapsing, and remitting course. Course of disease may last months to years with flares lasting for weeks. Rarely, there is progression to systemic involvement of liver, kidneys, adrenals, joints, and heart. hydroxychloroquine, azathioprine, methotrexate, or cyclophosphamide.

Prognosis

Figure 5.12.1 Nodular vasculitis. Dense mixed lobular inflammatory infiltrate with areas of hemorrhage.

Figure 5.12.2 Nodular vasculitis. Mixed lobular infiltrate predominated by neutrophils but including eosinophils, lymphocytes, and plasma cells.

SUBCUTIS Figure 5.12.4 Nodular vasculitis. Lobules show lipophagic fat necrosis with formation of fat cysts associated with foamy macrophages. Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2023

Figure 5.12.3 Nodular vasculitis. Neutrophils infiltrate the walls of vessels of varying size with mural fibrinoid change and leukocytoclastic debris. Note that the vasculitic change involves both arterial and venous vessels, not exclusively medium-sized arterioles.

5 DISORDERS OF THE