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Gao Y, Jin H. Livedoid vasculopathy and its association with genetic variants: A systematic review. Int Wound J 2021; 18:616-625. [PMID: 33686673 PMCID: PMC8450804 DOI: 10.1111/iwj.13563] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/29/2022] Open
Abstract
Livedoid vasculopathy (LV) is considered a disease of hypercoagulability. Association of LV with genetic variants is poorly characterised and large‐scale genetic association studies have not been performed. The aim of the study was to systematically review variants in LV patients and to analyse the available clinical data. A systematic search of the literature in PubMed and Embase databases was performed to identify articles investigating genetic variation in LV patients. Thirty studies or case reports were identified that reported 265 LV patients tested for at least one out of six genetic variations. Among them, PAI‐1 ‐675 4G/5G was the most common, accounting for 85.26% (81/95). Heterozygous 4G/5G was the major genotype. PAI‐1 A844G, MTHFR C677T, and MTHFR A1298C were the second, third, and fourth most common variants in LV patients. Prothrombin G20210A and Factor V G1691A were mainly present in LV patients from Europe, North America, and South America. This review highlights the associations between LV and genetic variants. The distribution of variants may be geographically or ethnicity dependent; however, large sample case‐control studies are needed to clarify associations.
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Affiliation(s)
- Yimeng Gao
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Rujitharanawong C, Chularojanamontri L, Trakanwittayarak S, Pinkaew S, Nuttawong S. Livedoid vasculopathy: Clinical course and long-term outcome in Asian patients with a review of the literature. Dermatol Ther 2020; 34:e14569. [PMID: 33219608 DOI: 10.1111/dth.14569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/06/2020] [Accepted: 11/14/2020] [Indexed: 11/30/2022]
Abstract
Livedoid vasculopathy (LV) is an uncommon, chronic, and recurrent thrombo-occlusive vascular disorder. Data specific to LV in Thai population remains scarce. This study aimed to evaluate the clinical course and treatment outcomes of LV in Thai patients, and to perform a literature review for studies that reported on anticoagulant treatment in LV. Seventy-four patients with a mean age of 37.6 ± 14.7 years were included. The female to male ratio was 5.2:1, and the median follow-up was 10.5 months. Most patients had primary LV disorder. Forty-eight patients were improved with treatments, with a median duration of 11.4 months. Combination treatments were commonly used, including anti-inflammatories, antiplatelets, and immunosuppressants. Add-on therapy with anticoagulant or psoralen plus ultraviolet-A (PUVA) led to disease improvement in a majority of the patients treated. Kaplan-Meier analysis demonstrated that 38.5%, 53.7%, and 57.9% would have disease improvement at 1, 2, and 3 years, respectively. Of 39 studies (n = 219) that reported on anticoagulant treatment in LV, anticoagulant drug was used as monotherapy in 104 patients. The mean duration of anticoagulant treatment was 7.2 ± 3.8 months, which led to disease improvement in 97 patients (93.3%). Bleeding side effect was found in 9 patients (8.7%). The highest incidence of LV was found among females aged 30 to 40 years. Combination therapy with anti-inflammatory drugs, antiplatelet drugs, and immunosuppressants led to disease improvement. The observed efficacy of add-on PUVA or anticoagulant is promising and should be further investigated. Further studies are needed to guide the development of an LV management guideline.
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Affiliation(s)
- Chuda Rujitharanawong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leena Chularojanamontri
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Sumruay Pinkaew
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sasipha Nuttawong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Abstract
GENERAL PURPOSE To discuss the pathogenesis and clinical features of wounds caused by microthrombi formation under the following categories of systemic diseases: cold-related and immune-complex deposition diseases, coagulopathies, abnormalities in red blood cell structure, emboli, and vasospasm. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to:1. Recall the etiology, risk factors, and pathophysiology of the various types of microthrombotic wounds.2. Describe the clinical manifestations and treatment of the various types of microthrombotic wounds. ABSTRACT Typical wounds such as diabetic foot ulcers, venous leg ulcers, pressure ulcers, and arterial ulcers are responsible for more than 70% of chronic wounds. Atypical wounds have broad differential diagnoses and can sometimes develop as a combination of different conditions. Regardless of the etiology, impaired blood circulation is characteristic of all chronic and acute wounds. Chronic wounds associated with microthrombi formation are an important group of atypical wounds commonly linked to an underlying systemic disease. In this perspective article, the pathogenesis and clinical features of wounds caused by microthrombi formation are discussed under the following categories of systemic diseases: cold-related and immune-complex deposition diseases, coagulopathies, abnormalities in red blood cell structure, emboli, and vasospasm.
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Parsi K, Kang M, Abbott L. Livedo vasculopathy: Ablation of the affected vessels to prevent recurrent ulcerations. Phlebology 2019; 34:582-597. [PMID: 30691377 DOI: 10.1177/0268355519825894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Livedo vasculopathy is a cutaneous thrombotic microangiopathy favouring the lower legs characterised by an intense reticulate pigmentation, atrophie blanche and recurrent painful stellate ulcerations. There is a strong association with antiphospholipid syndrome, thrombophilic abnormalities, factor V Leiden mutation and more recently, lipoprotein A. Thrombotic occlusion of the dermal venules is the key pathology in livedo vasculopathyand there is no associated vasculitis. Anticoagulation and other currently recommended conservative therapies do not influence the rate of ulcer healing. Method Concurrent venous hypertension was treated with endovenous ablative methods. In addition, vessels deemed to be involved in the process of vasculopathy, irrespective of their reflux status were identified on duplex ultrasound or by sight and ablated using endovenous laser and/or sclerotherapy. Results Five patients received endovenous intervention while two patients did not undergo any procedures. One patient requested a delay in interventions due to her circumstances and the other patient had multiple contraindications and comorbidities. On long-term follow-up, the intervention achieved complete ulcer healing and resolution of pain without any recurrence in four treated patients. Conclusion We recommend ablative venous interventions in suitable patients with livedo vasculopathy to prevent recurrent ulcerations. Compression should be considered as an adjunct treatment.
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Affiliation(s)
- Kurosh Parsi
- Department of Dermatology, St. Vincent's Hospital, Sydney, Australia.,Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research (AMR), St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Mina Kang
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Lisa Abbott
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research (AMR), St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of Sydney, Australia
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Chen W, Fan L, Wang Y, Deng X. Treatment application of rivaroxaban in Chinese patients with livedoid vasculopathy. J Pain Res 2017; 10:621-624. [PMID: 28360530 PMCID: PMC5364015 DOI: 10.2147/jpr.s133462] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Livedoid vasculopathy (LV) is a chronic prothrombotic disease of cutaneous micro-circulation resulting in cutaneous ischemia and infarction. As a rare disease, LV has an estimated incidence of ten cases per million. Not only correct diagnosis but also effective treatments are very difficult for patients with LV. Due to the lack of large-scale studies in this rare disease, LV poses a great challenge to the doctors, and existing treatment has always been an individual attempt with off-label application. The main goals in the treatment of patients with LV are to avoid the repeated occurrence of active cutaneous lesions and prevent painful ulceration and irreversible scarring. The current report describes the cases of three Chinese patients with LV receiving rivaroxaban treatment, an oral direct inhibitor of factor Xa inhibitor, and observes the treatment effect of rivaroxaban during the follow-up. As an injection-free alternative to low-molecular-weight heparin (LMWP) and monitoring-free alternative to warfarin, rivaroxaban improves the quality of life and enhances the compliance of patients. All patients consider rivaroxaban as more tolerable than previous drugs and, therefore, continue the application of rivaroxaban, effectively improving the treatment effect of drugs and successfully avoiding the repeated occurrence of active cutaneous lesions. Treatment application of rivaroxaban in Chinese patients with LV successfully avoids the recurrence of active cutaneous lesions and prevents the progressive ulceration and scarring.
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Affiliation(s)
- Wenji Chen
- Department of Rheumatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya
| | - Lina Fan
- Department of Rheumatology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya
| | - Yanyan Wang
- Department of Rheumatology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Xiaohu Deng
- Department of Rheumatology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
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Atrophie blanche: is it associated with venous disease or livedoid vasculopathy? Adv Skin Wound Care 2016; 27:518-24; quiz 525-6. [PMID: 25325229 DOI: 10.1097/01.asw.0000455098.98684.95] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this learning activity is to provide information about the etiology and treatment of atrophie blanche. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After participating in this educational activity, the participant should be better able to:1. Discuss the pathophysiology of atrophie blanche.2. Explore treatment options for livedoid vasculopathy. ABSTRACT Atrophie blanche (AB) is a porcelain-white scar that may be seen at the base of a healed ulcer or in association with livedoid vasculopathy (LV). The term AB originally had been used synonymously with LV, whereas LV is a noninflammatory thrombotic condition presenting as either a primary or secondary event (often associated with coagulation).
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Winchester D, Drage L, Davis M. Response of livedoid vasculopathy to rivaroxaban. Br J Dermatol 2015; 172:1148-50. [DOI: 10.1111/bjd.13428] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D.S. Winchester
- Department of Dermatology; Mayo Clinic; 200 First St SW Rochester MN 55905 U.S.A
| | - L.A. Drage
- Department of Dermatology; Mayo Clinic; 200 First St SW Rochester MN 55905 U.S.A
| | - M.D.P. Davis
- Department of Dermatology; Mayo Clinic; 200 First St SW Rochester MN 55905 U.S.A
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Lima RSA, Maquiné GÁ, Talhari C, Encarnação ICL, Schettini APM, Santos M. Livedoid vasculopathy as a marker of systemic disease: report of two cases. An Bras Dermatol 2014; 89:822-4. [PMID: 25184928 PMCID: PMC4155967 DOI: 10.1590/abd1806-4841.20142897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 09/14/2013] [Indexed: 11/22/2022] Open
Abstract
The livedoid vasculopathy is an obstructive vascular process of etiology not yet
fully known, being possibly associated with several prothrombotic events. It is
clinically characterized by the presence of painful and recurring purpuric lesions,
which usually suffer ulceration and evolve with formation of white atrophic scars
usually located in the lower limbs. Two cases are here reported of painful ulcerated
lesions on the lower limbs, in which the identification of VL enabled the diagnosis
of systemic diseases.
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Alavi A, Hafner J, Dutz JP, Mayer D, Sibbald RG, Criado PR, Senet P, Callen JP, Phillips TJ, Romanelli M, Kirsner RS. Livedoid vasculopathy: An in-depth analysis using a modified Delphi approach. J Am Acad Dermatol 2013; 69:1033-1042.e1. [DOI: 10.1016/j.jaad.2013.07.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/16/2013] [Accepted: 07/18/2013] [Indexed: 10/26/2022]
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Thornsberry LA, LoSicco KI, English JC. The skin and hypercoagulable states. J Am Acad Dermatol 2013; 69:450-62. [PMID: 23582572 DOI: 10.1016/j.jaad.2013.01.043] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 01/19/2013] [Accepted: 01/25/2013] [Indexed: 11/19/2022]
Abstract
Hypercoagulable states (HS) are inherited or acquired conditions that predispose an individual to venous and/or arterial thrombosis. The dermatologist can play a vital role in diagnosing a patient's HS by recognizing the associated cutaneous manifestations, such as purpura, purpura fulminans, livedo reticularis, livedo vasculopathy (atrophie blanche), anetoderma, chronic venous ulcers, and superficial venous thrombosis. The cutaneous manifestations of HS are generally nonspecific, but identification of an abnormal finding can warrant a further workup for an underlying thrombophilic disorder. This review will focus on the basic science of hemostasis, the evaluation of HS, the skin manifestations associated with hypercoagulability, and the use of antiplatelet and anticoagulant therapy in dermatology.
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Affiliation(s)
- Laura A Thornsberry
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
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Kerk N, Drabik A, Luger T, Schneider S, Goerge T. Rivaroxaban prevents painful cutaneous infarctions in livedoid vasculopathy. Br J Dermatol 2013; 168:898-9. [DOI: 10.1111/bjd.12100] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Criado PR, Rivitti EA, Sotto MN, Valente NYS, Aoki V, Carvalho JFD, Vasconcellos C. Livedoid vasculopathy: an intringuing cutaneous disease. An Bras Dermatol 2012; 86:961-77. [PMID: 22147037 DOI: 10.1590/s0365-05962011000500015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 12/27/2010] [Indexed: 11/21/2022] Open
Abstract
Livedoid vasculopathy is a skin disease that occludes the blood vessels of the dermis. It has a pauciinflammatory or non-inflammatory nature. It is characterized by the presence of macular or papular, erythematous-purpuric lesions affecting the legs, especially the ankles and feet, and producing intensely painful ulcerations, which cause white atrophic scars called "atrophie blanche". This review includes studies and case reports found in the medical literature regarding the etiopathogenic associations of the disease, particularly those related to thrombophilia, their histopathological findings and the therapeutic approaches used in the difficult clinical management of these cases.
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Affiliation(s)
- Paulo Ricardo Criado
- Divisão de Dermatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
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Painless Livedoid Vasculopathy in a Patient with G20210A Prothrombin Gene Mutation. Case Rep Med 2012; 2012:910231. [PMID: 22988463 PMCID: PMC3440924 DOI: 10.1155/2012/910231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 08/09/2012] [Accepted: 08/09/2012] [Indexed: 12/03/2022] Open
Abstract
87 year old Caucasian female with chronic painless non-healing ulcers over malleoli was admitted to the hospital. On a physical examination, there were two bilateral and laterally located malleoli ulcers with no discharge. A thorough work up was done: lower extremities venous and arterial Doppler ultrasound did not show any evidence of venous and arterial disease respectively. Heterozygous G20210A Prothrombin gene mutation was found, and the patient was started on anticoagulation. This case reports highlights a possibility of a painless livedoid vasculopathy presentation in a patient without significant past thrombotic events. Therefore, it is important to consider livedoid vasculopathy in the differential in a patient with painless ulcerative, atrophic and/or nodular skin lesions over the shins and malleoli.
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Gonzalez-Santiago TM, Davis MDP. Update of management of connective tissue diseases: livedoid vasculopathy. Dermatol Ther 2012; 25:183-94. [DOI: 10.1111/j.1529-8019.2012.01490.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Association between peripheral vascular endothelial dysfunction and livedoid vasculopathy. J Am Acad Dermatol 2011; 67:107-12. [PMID: 21982058 DOI: 10.1016/j.jaad.2011.07.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 06/27/2011] [Accepted: 07/21/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Livedoid vasculopathy (LV) is a disease characterized by multiple painful and recurrent ulcerations on the feet, accompanied by atrophic scars. Many researchers suggest that a hypercoagulable status is the pathogenetic factor for LV. However, the cause of LV remains elusive. OBJECTIVE We sought to determine if endothelial dysfunction is present in patients with LV. METHODS This prospective study included 16 patients with LV and active ulcers and 16 matched control subjects. We reviewed detailed clinical parameters, including antinuclear antibody, high-sensitivity C-reactive protein, protein C, protein S, homocysteine, anti-SSA, anti-SSB, anticardiolipin antibody, and serum lipid profiles. Flow-mediated vasodilation of the brachial artery was used as an indicator of vascular endothelial function using high-resolution 2-dimensional ultrasonic imaging. RESULTS Blood pressure, blood biochemistry, high-sensitivity C-reactive protein, and homocysteine were not significantly different in patients with LV and control subjects. Nitroglycerin-mediated vasodilation was not significantly different in patients with LV and control subjects. However, flow-mediated vasodilation was much less in patients with LV than in the control group (3.58 ± 2.32% vs 7.51 ± 2.40%, P < .001). LIMITATIONS The study was performed at a single site with a limited sample size. CONCLUSION Peripheral vascular endothelial dysfunction was demonstrated in patients with LV by reduction of brachial flow-mediated vasodilation.
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Bollmann PW, Shimada AK, Michalany NS, Manhani ARDAB, Giglio AD. Livedoid vasculopathy: fast involution after anticoagulant and hyperbaric oxygen therapy. EINSTEIN-SAO PAULO 2011; 9:212-5. [DOI: 10.1590/s1679-45082011rc1676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The livedoid vasculopathy is a rare condition characterized by the presence of recurrent painful ulcers in distal extremities of lower limbs. Histologically there is thickness of dermal vessels, occlusion of its light by fibrin thrombi associated with minimal inflammatory infiltrate. It might occur as an isolated condition or be associated with an underlying systemic disease, including coagulation and collagen disorders, or neoplasms. Because it is a rare disease there is no consensus for its treatment. We report a case of a 41-year-old man with painful ulcers in the lower extremities. We did not find any associated diseases. The lesions improved dramatically after treatment with anticoagulant and hyperbaric therapy. We concluded that anticoagulation associated with hyperbaric oxygenation may be benefit for the treatment of patients with livedoid vasculopathy. However, further studies should be done with a larger population to confirm our results.
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KISHIBE M, KOMATSU S, ISHIDA-YAMAMOTO A, IIZUKA H. Livedo vasculopathy associated with methylenetetrahydrofolate reductase C677T homozygosity. J Dermatol 2011; 39:91-4. [DOI: 10.1111/j.1346-8138.2011.01213.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Criado PR, Rivitti EA, Sotto MN, de Carvalho JF. Livedoid vasculopathy as a coagulation disorder. Autoimmun Rev 2011; 10:353-60. [DOI: 10.1016/j.autrev.2010.11.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
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Khenifer S, Thomas L, Balme B, Dalle S. Livedoid vasculopathy: thrombotic or inflammatory disease? Clin Exp Dermatol 2010; 35:693-8. [DOI: 10.1111/j.1365-2230.2009.03732.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sepehr A, Wenson S, Tahan SR. Histopathologic manifestations of systemic diseases: the example of cutaneous lupus erythematosus. J Cutan Pathol 2010; 37 Suppl 1:112-24. [PMID: 20482683 DOI: 10.1111/j.1600-0560.2010.01510.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alireza Sepehr
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
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Di Giacomo TB, Hussein TP, Souza DG, Criado PR. Frequency of thrombophilia determinant factors in patients with livedoid vasculopathy and treatment with anticoagulant drugs - a prospective study. J Eur Acad Dermatol Venereol 2010; 24:1340-6. [DOI: 10.1111/j.1468-3083.2010.03646.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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OSADA SI, KIMURA Y, KAWANA S. Case of livedoid vasculopathy with peripheral neuropathy successfully treated with low-dose warfarin. J Dermatol 2010; 37:98-101. [DOI: 10.1111/j.1346-8138.2009.00754.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Khenifer S, Thomas L, Balme B, Dalle S. Livedoid vasculiltis associated with a double heterozygous Factor V Leiden and prothrombin G20210A gene mutations. Clin Exp Dermatol 2009; 34:e811-3. [DOI: 10.1111/j.1365-2230.2009.03541.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Waisse-Priven S, Jurj G, Lima Thomaz LC, Tierno SA, Filho WL, Sos AB. Homeopathic treatment in resistant livedoid vasculopathy: case report. HOMEOPATHY 2009; 98:165-8. [DOI: 10.1016/j.homp.2009.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Revised: 03/06/2009] [Accepted: 04/20/2009] [Indexed: 10/20/2022]
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Criado PR, Rivitti EA, Vasconcellos C, Valente NYS, Martins JEC. Manifestações cutâneas das trombofilias. An Bras Dermatol 2008. [DOI: 10.1590/s0365-05962008000600002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O escopo deste artigo é revisar os estados de hipercoagulabilidade sangüínea (trombofilias) mais provavelmente encontrados por dermatologista. Seus sinais cutâneos incluem o livedo reticular, necrose cutânea, ulcerações e isquemia digital, púrpura retiforme, além de úlceras nas pernas. Revisamos seu tratamento adequado, bem como ressaltamos as manifestações cutâneas que impõem pesquisa laboratorial de trombofilias e os exames indicados nessas situações.
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