Author Affiliations: Department of Dermatology, University of Maryland, Baltimore (Drs Tuchinda, Tammaro, and Gaspari); Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Dr Tuchinda); and Department of Dermatology, University la Sapienza, Rome, Italy (Dr Tammaro).
We previously reported the case of a 33-year-old woman who was diagnosed as having livedoid vasculopathy (LV) associated with plasminogen activator inhibitor-1 (PAI-1) promoter homozygosity (4G/4G).1 In patients with homozygosity for the 4G allele, high levels of PAI-1 may be associated with increased risk of venous thromboembolism, coronary disease, and poor outcome of stroke.1 This patient was successfully treated with infusions of tissue plasminogen activator (tPA) (10 mg/d for 2 weeks) after failed treatments with anti-inflammatory and antiplatelet therapies.
Tuchinda P, Tammaro A, Gaspari AA. Successful Long-term Use of Intravenous Immunoglobulin to Treat Livedoid Vasculopathy Associated With Plasminogen Activator Inhibitor-1 Promoter Homozygosity. Arch Dermatol. 2011;147(10):1224-1225. doi:10.1001/archdermatol.2011.274