Negative Results, Positive Outcome: A Case of Primary Livedoid Vasculopathy With an Elusive Laboratory Workup

Livedoid vasculopathy (LV) is a chronic, recurrent thrombotic vasculopathy characterized by painful ulcerations on the lower extremities, which heal slowly and leave atrophic white scars known as "atrophie blanche." This report presents the case of a 31-year-old woman with a 4-year history...

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Published in:JIM - high impact case reports 2024-01, Vol.12, p.23247096241266090
Main Authors: Al-Obaidi, Ahmed Dheyaa, Sabeeh, Shireen Kh, Mohammed, Maab Jasim, Othman, Assalah, Algburi, Yousif Ahmed, Hashim, Hashim Talib, Alhatemi, Ahmed Qasim Mohammed, Al Hilali, Zahraa, Al-Attabi, Bilal Riyadh Taresh, Al-Awad, Abdullah
Format: Article
Language:English
Subjects:
Adult
Anticoagulants - therapeutic use
Biopsy
Case Report
Female
Humans
Livedo Reticularis - drug therapy
Livedo Reticularis - pathology
Nifedipine - therapeutic use
Pentoxifylline - therapeutic use
Skin - pathology
Treatment Outcome
Warfarin - therapeutic use
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Summary:Livedoid vasculopathy (LV) is a chronic, recurrent thrombotic vasculopathy characterized by painful ulcerations on the lower extremities, which heal slowly and leave atrophic white scars known as "atrophie blanche." This report presents the case of a 31-year-old woman with a 4-year history of recurrent painful ulcerations on her legs and feet. A skin biopsy revealed findings consistent with LV, and an exhaustive laboratory workup ruled out secondary causes such as thrombophilia, malignancies, autoimmune diseases, and peripheral arterial disease. The patient showed remarkable improvement with a treatment regimen of pentoxifylline, nifedipine, and warfarin, resulting in complete ulcer resolution and sustained remission over 5 months. Our case highlights the importance of a comprehensive diagnostic approach and a multidisciplinary treatment strategy in managing primary LV to achieve remission and prevent recurrence of skin ulcerations.
ISSN:2324-7096
2324-7096
DOI:10.1177/23247096241266090