CUTANEOUS POLYARTERITIS-NODOSA RESISTANT TO COMBINED CORTICOSTEROID AND IMMUNOSUPPRESSIVE THERAPY - SUCCESSFUL TREATMENT WITH INTRAVENOUS IMMUNOGLOBULINS

Introduction. Cutaneous polyarteritis nodosa is a subset of polyarteri tis nodosa (PAN) characterized by a good prognosis because of the abse nce of severe visceral involvement. Dapsone, colchicin, non steroidal anti-inflammatory drugs are the first line treatments of cutaneous PAN . Corticosteroids are an alternative therapy. Case-report. A case of c utaneous PAN followed for 6 years is reported. Dapsone, colchicin, cor ticosteroids and cyclophosphamide have failed to control cutaneous les ions. Intravenous immunoglobulins 400 mg/kg/d five day monthly for 5 m onths was successfull, but a cutaneous relapse occurred 3 months later which was another time controlled with intravenous immunoglobulins. D iscussion. Some cases of necrotizing vasculitis have been treated with intravenous immunoglobulins. This is the first reported case of cutan eous PAN treated with intravenous immunoglobulins. Because of the lack of controlled studies, the indications of intravenous immunoglobulins in vasculitis are restricted to those resistant to corticosteroids an d immunosuppressive therapy.