Polyarteritis nodosa physical examination

Polyarteritis nodosa Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.

Physical Examination

• Physical examination plays an important role in diagnosing PAN.
• Arteritis can be suspected with the presence of multiple mononeuropathies.
• Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing PAN.

Skin

• Skin examination of patients with PAN can show:
  • Livedo reticularis
  • Ulcerations
    • Ulcers can be seen on the lower extremeties
  • Digital ischemia
    • Splinter hemorrages can be seen.
    • Gangrene can also be seen.
  • Nodules
    • Nodules are a rare finding.
    • Most commonly seen on lower extremity. Cutaneous symptoms in PAN include the following ^{null 6} (see the images below):
      • Livedo reticularis that does not blanch with active pressure
      • Ulcerations - Especially on the lower extremities, near the malleoli and on the calf
      • Digital ischemia - May be accompanied by splinter hemorrhages and, sometimes, gangrene
      • Nodules - Usually on the lower extremities (like ulcers); nodules are the least common skin manifestation of PAN