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Volume 354:2393-2394 June 1, 2006 Number 22
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Medical Mystery: Gangrene and Cutaneous Nodules — The Answer

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by Schanz, S.
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To the Editor: The Medical Mystery in the April 6 issue1 involved a 62-year-old man who presented with a one-month history of digital gangrene in the right hand (Figure 1A). The skin of his arms and legs had mottled discolorations with palpable cutaneous nodules (Figure 1B). A deep incisional-biopsy specimen from a cutaneous nodule revealed occluded middle-sized arteries with lymphoplasmacellular and neutrophilic infiltration (Figure 1C). On the basis of the clinical and histologic findings, the diagnosis of cutaneous polyarteritis nodosa was made. The patient underwent amputation of the necrotic regions. During glucocorticoid treatment, new . . . [Full Text of this Article]



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