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Livedoid vasculopathy is a blood vessel disorder that causes painful ulcers and scarring (atrophie blanche) on the feet and lower legs. These symptoms can persist for months to years and the ulcers often recur. Livedoid vasculopathy lesions appear as painful red or purple marks and spots that may progress to small, tender, irregular ulcers. Symptoms tend to worsen in the winter and summer months, and affect women more often then men. Livedoid vasculopathy may occur alone or in combination with another condition, such as lupus or thrombophilia.
Source: GARD Last updated on 05-01-20
Treatment of livedoid vasculopathy aims to reduce pain, ulceration and scarring. General treatment measures may involve protecting the skin from injury and irritants, removing dead tissue from the ulcers, treating infection with antibiotics, elevating legs, compression therapy, and avoiding smoking and hormonal contraceptives. Treatments will also be given to address any co-occurring conditions such as lupus or thrombophilia. Drugs that aim to improve blood flow or prevent blood clotting may also be considered. Examples of these treatments, include:
Antiplatelet agents (e.g. aspirin, dipyridamole)
Fibrinolytic agents (e.g. danazol, tissue plasminogen activator)
Anticoagulant agents (e.g. subcutaneous heparin injections, oral warfarin)
Low-dose danazol (200 mg/day orally)
Pulsed intravenous immunoglobulin
Psoralen plus ultraviolet A (PUVA) therapy
Niacin (nicotinic acid)
Currently there are no established guidelines for treatment. Decisions for treatment are made based on the clinicians clinical experience and specific patient characteristics. We strongly recommend that you discuss this information and your treatment options further with a trusted healthcare professional.
Last updated on 05-01-20
Hairston BR et al., Livedoid Vasculopathy: Further Evidence for Procoagulant Pathogenesis. Arch Dermatol. 2006;142(11):1413-1418.
Last updated on 04-27-20
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