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There is a well-established relationship between vasculitides and malignancy. The most common type of cutaneous vasculitis associated with both hematologic and solid organ malignancy is leukocytoclastic vasculitis, a small-vessel vasculitis.1, 2, 3, 4 Other systemic vasculitides with cutaneous manifestations seen in association with malignancy include systemic polyarteritis nodosa (PAN) and the antineutrophil cytoplasmic antibody-associated vasculitides, including microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis.3 Cutaneous polyarteritis nodosa (cPAN), a rare variant of systemic PAN, is a skin-limited small-to-medium vessel vasculitis affecting patients of all ages.5 Clinically, cPAN and systemic PAN present similarly with initial cutaneous findings of livedo reticularis and tender subcutaneous nodules, which are most commonly found on the lower extremities.5 Cutaneous ulceration and retiform purpura may also be seen in both conditions. Cutaneous PAN is not commonly associated with malignancy. We present a case of cPAN developing in the context of underlying chronic myelogenous leukemia (CML) and resolving with treatment for CML, supportive of a paraneoplastic presentation of cPAN.

Psoriasis and psoriatic arthritis are chronic inflammatory diseases affecting the skin and joints, respectively. Psoriasis and psoriatic arthritis are associated with a high comorbidity burden as well as negative impact on quality of life. Impact on health-related quality of life is optimized when both skin and joint manifestations are effectively treated. The identification of key cytokines involved in disease pathogenesis has led to the development of several therapeutic options for psoriatic disease. When selecting a therapy, it is important to consider disease severity, psoriasis disease subtypes or domains of psoriatic arthritis, comorbidities, patient preference for treatment, among other factors. This review summarizes current biologic and small molecule treatment options as well as emerging therapies for moderate-to-severe adult plaque psoriasis and psoriatic arthritis.

Nutritional deficiency is rare in developed countries, but can be acquired from decreased nutrient intake, reduced absorption, and increased gastrointestinal excretion. We report a patient with acquired acrodermatitis enteropathica (AE) who exhibited low plasma zinc levels and concurrent nutritional deficiencies (pyridoxine, selenium and fatty acids). Our patient had undergone Roux-en-Y gastric bypass 13 years prior to presentation. The rash, consistent with AE clinically and histologically, nearly resolved one week after starting IV zinc supplementation, total parenteral nutrition, and micronutrient supplements. This case highlights the importance of long-term post-operative follow-up for gastric bypass patients who are at high risk for micronutrient and macronutrient deficiencies and illustrates the potential for rapid improvement with IV supplementation.