RESUMEN
Poliarterite nodosa cutânea é paniculite septal com vasculite acometendo artérias e arteríolas. É responsável pelo quadro de nódulos dolorosos, livedo reticular associado ou não a astenia, mialgia e artralgia. Difere da PAN clássica pela ausência do acometimento de vísceras.Os autores relatam um caso de Poliartrite Nodosa Cutânea em um homem de 25 anos que apresentou manifestações clínicas típicas e obteve resposta ao tratamento com pulsoterapia de corticóide associado ao AAS e pentoxifilina , e apresentam uma revisão de literatura sobre este diagnóstico.
Cutaneous polyarteritis nodosa is septal panniculitis with vasculitis affecting arteries and arterioles. It is responsible for painful nodules, livedo reticularis associated or not with asthenia, myalgia and arthralgia. Differing from the classic PAN by the absence of involvement of viscera. The authors report a case of polyarteritis nodosa Cutaneous in a 25 year old man who presented typical clinical manifestations and obtained response to treatment with corticosteroid pulse therapy associated with ASS and pentoxifylline, and present a literature review on this diagnosis.
RESUMEN
Human T-cell lumphotropic virus type I (HTLV-I) associated myelopathy / tropical spastic paraparesis (HAM/TSP) is the most common chronic myelopathy in Brazil. We present the case of a 53 year old man that fulfiled the diagnostic criteria for HAM/TSP but had at the magnetic resonance imaging (MRI) of the spinal cord evidences of syringohydromyelia at the C6-C7 and D2-D7 levels along with Chiari type I malformation. The clinical picture was more typical of HAM/TSP than of syringohydromyelia, which was probably asymptomatic. The present case clearly demonstrates that sorology and neuroimaging should be always use together. We conclude that, specially in places where HTLV-I is endemic, every patient with a spatic paraparesis, even with a radiological picture suggestive of a structural spinal cord lesion, should have a screening test for HTLV-I. The clinical picture must dictate the final direction of the diagnosis.