Diagnostic Approach for Cutaneous Polyarteritis Nodosa (PAN)

Diagnostic Features

• For patients with suspected cutaneous PAN, a deep-skin biopsy specimen is essential for diagnosis, as this is more likely to capture the medium-sized vessels affected in this condition, according to the American College of Rheumatology 1, 2
• Deep-skin biopsy is the gold standard for diagnosis, reaching medium-sized vessels of the dermis, as recommended by the American College of Rheumatology 1, 2
• Superficial skin punch biopsies should be avoided as they may miss the deeper vascular involvement, as noted by the American College of Rheumatology 1, 2
• Abdominal vascular imaging may be considered to exclude systemic involvement, as suggested by the American College of Rheumatology 3
• Failure to obtain a deep enough biopsy specimen can lead to missed diagnosis, highlighting the importance of proper biopsy technique, as emphasized by the American College of Rheumatology 1, 2