Livedoid vasculopathy: Case report and brief review of its therapy

A 58-year-old man, with purpuric pericapillary lesions in the lower limbs, for 20 years, associated with local hyperesthesia. The condition evolved with local burning extending to the back of the feet. Pentoxifylline, acetylsalicylic, diosmine, syvastatin and cilostazol were used. In the current consultation, he had erythema-vinous macules in the distal part of the thighs and on both legs ranging from a few mm to 2 cm in diameter associated with continuity solutions and white atrophies. With a suspicion of Livedoid Vasculopathy, laboratory tests were performed: liver and kidney function tests, glucose, alkaline phosphatase, blood count, serum complement, ANF (antinuclear factor), urine summary, anti-RNP, native anti-DNA, anti-SLC-70, anti-U1 RNP, anti-ACA, dehydrogenases, fibrinogen, serology for syphilis, hepatitis B and C and HIV, all exams were normal, The CH50 was at 80 U/ml (normal up to 60 U/ml). The histopathological study of cutaneous fragment confirming the initial suspicion. Therapy for livedoid vasculopathy includes intravenous pulse immunoglobulin which has been shown to be effective and safe, providing responses, in some cases, from the first cycle (Kim et al 2015), and danazol, with high fibrinolytic power.