Livedoid Vasculitis in a Patient With Sjogren Syndrome Successfully Treated With Methotrexate

INTRODUCTION: Cutaneous vasculitis occurs in a sizable minority of patients with Sjogren syndrome. In addition, their response to different modalities of therapy is variable. CASE DESCRIPTION: We present a case of a 66-year-old female with Sjogren syndrome cutaneous vasculitis in whom combination treatment with Rituximab and Azathioprine failed to show a favorable response. However, methotrexate proved to be an excellent alternative. DISCUSSION: In cutaneous vasculitis, in addition to the necessary local therapy applied to the affected limbs, methotrexate produced a complete response when other treatment modalities failed. Therefore, it may be advisable to use methotrexate to treat cutaneous vasculitis before trying Rituximab. CONCLUSION: In cutaneous vasculitis associated with Sjogren syndrome, methotrexate can be an early effective therapeutic strategy.