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• Vol.64 No.1
• CLINICA NEUROL, 64: 33−38, 2024
• Vol.64 No.1 contents

Case Report

Mononeuropathy multiplex caused by cutaneous arteritis diagnosed by skin biopsies for emerging atypical erythema on upper limbs following neurological symptoms: a case report

Yamato Nakamura, M.D.^1）, Kiyohide Usami, M.D., Ph.D.^1）2）, Tomohiko Taniguchi, M.D.^1）3）, Saeko Nakajima, M.D., Ph.D.^4）, Yo Kaku, M.D., Ph.D.^4） and Ryosuke Takahashi, M.D., Ph.D.^1）

¹⁾ Department of Neurology, Kyoto University Graduate School of Medicine
²⁾ Department of Neurology, Japan Community Health Care Organization Yamato Koriyama Hospital
³⁾ Department of Neurology, Shizuoka General Hospital
⁴⁾ Department of Dermatology, Kyoto University Hospital

A 33-year-old female was admitted to our department complaining of multifocal paresthesia and weakness of the upper and lower extremities that had developed over the previous three months. She had also been undergoing treatment for atopic dermatitis with dupilumab, an anti-interleukin 4/13 receptor antibody. A nerve conduction study revealed multifocal axonal sensorimotor neuropathy of bilateral limbs. On admission, a small erythema appeared on her right forearm, but it was atypical for vasculitic skin lesions due to its location and time course. Nonetheless, a biopsy revealed medium-sized vessel vasculitis. The patient was therefore diagnosed with vasculitic neuropathy caused by cutaneous arteritis. Methylprednisolone pulse therapy with prednisolone and azathioprine markedly improved her symptoms. A skin biopsy is useful when mononeuropathy multiplex is suspected, even if the skin findings are atypical for vasculitic rash.
Full Text of this Article in Japanese PDF (2920K)

(CLINICA NEUROL, 64: 33−38, 2024)
key words: mononeuropathy multiplex, cutaneous arteritis, polyarteritis nodosa, dupilumab, COVID-19

(Received: 4-Aug-23)