Successful treatment of Group A β-hemolytic Streptococcus infection-associated juvenile cutaneous polyarteritis nodosa with tonsillectomy

Abstract

Cutaneous polyarteritis nodosa (cutaneous PAN) is a form of necrotizing vasculitis of small- and medium-sized arteries, primarily involving the skin. In juvenile cases, cutaneous PAN is known to be frequently associated with Group A β-hemolytic Streptococcus (GAS) infections.

We herein describe the first reported juvenile case of GAS-associated recurrent cutaneous PAN successfully improved with tonsillectomy. To avoid the use of steroids and immunosuppressive drugs, especially in juvenile cases, tonsillectomy is a possible treatment for GAS-associated recurrent cutaneous PAN.

Keywords:

• Cutaneous polyarteritis nodosa
• Group A β-hemolytic Streptococcus
• Tonsillectomy

Acknowledgements

We are grateful to Dr. Tetsuya Horita and Dr. Tatsuya Atsumi, Department of Medicine Ⅱ, Hokkaido University Graduate School of Medicine, for measuring anti-phosphatidylserine/ prothrombin antibodies; to Dr. Daiju Sakurai and other members of Otolaryngology, Graduate School of Medicine, Chiba University, for performing a tonsillectomy; to Dr. Brian Quinn for reviewing the manuscript.

Conflict of interest

None.