Livedoid Vasculopathy: A French Observational Study Including Therapeutic Options

Acta Derm Venereol. 2018 Oct 10;98(9):842-847. doi: 10.2340/00015555-2965.

Abstract

Livedoid vasculopathy is a rare thrombotic cutaneous disease. This observational study aimed to assess the clinical and biological features of livedoid vasculopathy and the efficacy of treatments. Patients enrolled had typical livedoid vasculopathy both clinically and histologically. Investigation of thrombophilia was performed. Electromyography was undertaken in the presence of symptoms suggesting peripheral neuropathy. Eighteen women and 8 men were included, with a mean age of 35.5 years at onset. Twenty patients had at least one thrombophilia factor. Ten patients had a peripheral neuropathy with 2 of these patients demonstrating a specific thrombo-occlusive vasculopathy on muscle biopsy. Anticoagulation with low molecular weight heparin was the most prescribed therapy and was associated with the best outcome (effective in 14 patients). Eight patients had severe disease refractory to anticoagulation and required intravenous immunoglobulins, producing a good response in 6 patients.

Keywords: intravenousimmunoglobulins; livedoidvasculopathy; lowmolecularweightheparin; peripheralneuropathy; thrombophilia; throm­bosisofdermalvessels.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Administration, Intravenous
  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Anticoagulants / administration & dosage*
  • Blood Coagulation / drug effects
  • Child
  • Female
  • France / epidemiology
  • Heparin, Low-Molecular-Weight / administration & dosage*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunologic Factors / administration & dosage*
  • Livedo Reticularis / blood
  • Livedo Reticularis / drug therapy*
  • Livedo Reticularis / epidemiology
  • Livedo Reticularis / immunology
  • Male
  • Middle Aged
  • Peripheral Nervous System Diseases / epidemiology
  • Risk Factors
  • Thrombophilia / blood
  • Thrombophilia / drug therapy
  • Thrombophilia / epidemiology
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight
  • Immunoglobulins, Intravenous
  • Immunologic Factors