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November 2006

Livedoid VasculopathyWhat It Is and How the Patient Should Be Evaluated and Treated

Arch Dermatol. 2006;142(11):1481-1482. doi:10.1001/archderm.142.11.1481

In this issue of the ARCHIVES are 2 articles that aid us in defining associated conditions in patients with livedoid vasculopathy (LV). Hairston et al1 demonstrate that thrombophilic conditions occur frequently in patients with LV, including inherited abnormalities and acquired disease. In addition, they note a wide variety of associated conditions, including connective tissue diseases and neoplasia. Deng et al2 used tissue plasminogen activator (tPA) to successfully manage LV in a patient who was found to have elevated levels of plasminogen activator inhibitor-1 owing to a homozygous mutation of the plasminogen activator inhibitor-1 promoter. They note that patients with elevated levels of plasminogen activator inhibitor-1 have a propensity for thrombotic disorders. Their patient experienced 4 relapses of LV generally associated with discontinuation of antithrombotic therapy. In each instance, the lesions responded to reinstitution of tPA infusions.

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