Livedoid vasculitis is a clinicopathologic entity that is often idiopathic and whose incidence is unknown.1 It is manifested by chronic and painful skin ulceration, typically on the distal lower extremities. Healing lesions frequently leave hyperpigmented areas and atrophic scars. Histological findings include microthrombosis and subendothelial hyalinization of the dermal blood vessels without an associated vasculitis. We describe a patient with livedoid vasculitis with an inherited hypercoagulable trait, the prothrombin G20210A gene mutation.