만성 B형 간염 환자의 급성 악화 후 발생한 피부 결절 다발동맥염과 류마티스관절염 = A Case of Rheumatoid arthritis and cutaneous polyarteritis nodosa in Chronic hepatitis B with acute exacerbation

다국어 초록 (Multilingual Abstract)

Cutaneous polyarteritis nodosa(CPAN) is a rare vascular disorder that affects small and medium-sized arteries in the reticular dermis and subcutaneous tissue. It has been described as a distinct clinical entity with benign and a chronic prolonged course without systemic involvement.
Hepatitis B virus-related polyarteritis nodosa (HBV-related PAN) is typical form of classic PAN. Its pathogenesis is not well known, but considered an immune complex-mediated disease. The patients with HBV-related PAN often present with malignant hypertension, orchitis, and vascular nephropathy. But, HBV-related CPAN has been rarely reported.
Rheumatoid vasculitis is a complication of rheumatoid arthritis that can be lead to variety of clinically significant skin and systemic conditions, It has been reported before or at the time of rheumatoid arthritis diagnosis but is usually seen an average of 10 to 14 years after arthritis onset. The histological features of cutaneous vasculitis in rheumatoid arthritis overlapped both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa. But polyarteritis nodosa-like rheumatoid vasculitis has rarely been reported. We report a case of rheumatoid arthritis and cutaneous polyarteritis nodosa in a chronic hepatitis B with acute exacerbation.