Livedoid vasculopathy and its differential diagnosis

Abstract

Livedovaskulopathie und ihre differenzialdiagnostische Abgrenzung Phlebologie 2015; 44: 43–44 DOI: http://dy.doi.org/10.12687/phleb2246-1-2015 Received: October 22, 2014 Accepted: Oktober 24, 2014 Livedoid vasculopathy (LV) is a chronically recurring disease of the cutaneous microcirculation. Vascular occlusions develop in the capillary blood supply as a result of excessive coagulation activation. The overlying dependent skin areas are thus insufficiently perfused, leading to ischaemia. If this situation persists, it results in infarction with necrosis and ulceration. The ischaemic phase is very painful and severely impairs the affected patients’ quality of life. In the majority of cases, the cause of the excessive coagulation activity cannot be definitively established. Nevertheless, the patient is recommended to present in an outpatient department for coagulation disorders. In this chronically recurring disorder, close co-operation is necessary between physician and patient, in order to ensure an ideal risk-benefit ratio during long-term anticoagulation treatment. The disease is subject to seasonal fluctuation with an activity spike during the summer months. This is not a hard and fast rule, however, as there are also some patients who are more affected in the winter months and some who suffer from LV throughout the whole year.