Adult cutaneous periarteritis nodosa and dental infections. Role of streptococci.

Introduction. - Periarteritis nodosa can be associated with streptococcal i nfections in children. We report two cases of adult cutaneous periarteritis nodosa that disappeared after the treatment of dental infection. Exegesis. - A 23-year-old woman presented with necrotic ulceration on the l egs for 6 months, with a histology of necrotizing vasculitis. Many sites of dental infections could be noted. Immunological data were negative and so were serologies of hepatitis. Corticosteroid therapy failed. The teeth remo val with antibiotic therapy allowed the disappearance of cutaneous lesions in a month. A 26-year-old woman was hospitalized for growing thin, fever, d iffuse arthralgia and myalgia and cutaneous nodules on the legs with necrot izing vasculitis on dermal vessels at histological analysis. The biology sh owed no pecularity Radiography of the teeth showed many dental infection si tes. The removal of six teeth with antibiotic therapy led to the disappeara nce of vasculitis in 6 weeks. Conclusion. - The search for an infectious problem is important when vascul itis is diagnosed, in particular periarteritis nodosa. The treatment of den tal infection could occasionally mean avoiding immunosuppressive therapy in certain cases. (C) 2001 Editions scientifiques et medicales Elsevier SAS.