Divisão de Dermatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brasil.
Published: October 2012
AI Article Synopsis
Article 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.
A 58-year-old female smoker diagnosed with myelodysplastic syndrome (MDS) presented with Raynaud's phenomenon and a "scleroderma-like" pattern on nailfold capillaroscopy. The capillaroscopic abnormalities were observed across all fingers, including those without clinical manifestations of onychomycosis. Over a two-year follow-up, there was no evidence of clinical or serological progression toward a connective tissue disease, particularly systemic sclerosis.
Chronic leg ulceration is a debilitating manifestation of hemoglobinopathies, and best management is uncertain. Livedoid vasculopathy (LV) is a cutaneous non-inflammatory thrombotic vasculopathy treated with anticoagulation that has been identified in hemoglobinopathy-associated chronic leg ulceration. However, most patients with hemoglobinopathy-associated ulcers do not undergo workup for secondary causes, and the prevalence and relevance of LV is unclear.
- Raynaud's phenomenon is a condition that causes spasms in blood vessels of the fingers, leading to reduced quality of life and often fails to respond to conventional treatments for over six months.
- A study involving six patients who underwent a new procedure called radial cortex transverse distraction showed promising results, with significant improvements in pain, skin color, and healing of finger ulcers.
- The follow-up indicated that this surgical method not only healed bone without complications but also effectively addressed symptoms of Raynaud's phenomenon, suggesting it could be a beneficial treatment option.
Livedoid vasculopathy (LV) is a rare vascular disorder characterized by excessive thrombosis of cutaneous vasculature, leading to dermal vessel occlusion, skin hypoxia, and ulceration. The nonspecific nature of its clinical manifestations often complicates diagnosis and inadequate oxygenation results in lesions that take longer to heal and are more susceptible to infections and complications. Despite its impact on patient quality of life, LV remains largely undocumented in the literature, making effective management challenging.
