Cutaneous polyarteritis nodosa (cutaneous PAN) is a particular form of vasculitis involving small and medium sized arteries. The disease can be differentiated from classic PAN by its limitation to the skin and lack of progression to visceral involvement. Usually it manifests with subcutaneous nodule, livedo reticularis and cutaneous ulceration. Arthralgia, myalgia, neuropathy and constitutional symptoms such as fever and malaise may also be present. Sometimes the diagnosis is difficult, being just based on clinical suspicion and skin histologic exam. In this paper the authors describe the case of cutaneous PAN in a 9 years old child with severe ischemic changes in the fingertips, and subcutaneous nodules as initial signs of cutaneous PAN and probable association with the group A beta hemolytic streptococcus (GABHS). The review of the literature shows that the cutaneous PAN in the childhood may be associated to streptococcal infection and, for this reason, a special care should be given for those under 10 years old due to the high risk of self amputation.
cutaneous polyarteritis nodosa; vasculitis; gangrene; group A beta hemolytic streptococci
