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January 2006

Warfarin Therapy for Livedoid Vasculopathy Associated With Cryofibrinogenemia and Hyperhomocysteinemia

Author Affiliations

Author Affiliations: Division of Dermatology, Department of Medicine, University of Louisville, Louisville, Ky.

Arch Dermatol. 2006;142(1):75-78. doi:10.1001/archderm.142.1.75

Background  Livedoid vasculopathy is an idiopathic, chronic disorder manifested by painful, purpuric macules on the lower extremities that superficially ulcerate, resulting in atrophic, stellate scars with peripheral telangiectasias and hyperpigmentation.

Observations  A 50-year-old man presented with recurrent, painful ulcerations on the medial aspect of his malleoli and calves. The clinical presentation, histologic findings, and results of laboratory evaluation confirmed the diagnosis of livedoid vasculopathy in this case. Despite being refractory to treatment with multiple other medications, the lesions responded dramatically to oral warfarin sodium therapy.

Conclusion  Treatment with warfarin may be a beneficial therapy for patients with livedoid vasculopathy.